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Hip Resurfacing is a special type of hip replacement which only resurfaces the joint surfaces of the hip, rather than removing the entire head of the femur. It may be recommended if you have advanced osteoarthritis and have exhausted the nonsurgical treatment options.
Unlike hip replacement, hip resurfacing is not suitable for all patients. Generally speaking, the best candidates for hip resurfacing are younger (less than 60), larger-framed patients (often, but not always male) with strong, healthy bone. Patients that are older, female, smaller-framed, with weaker or damaged bone are at higher risk of complications, such as femoral neck fracture. A comprehensive evaluation by Mr Slattery will help you determine if you are a candidate for hip resurfacing.
In a traditional total hip replacement, the head of the thighbone (femoral head) and the damaged socket (acetabulum) are both removed and replaced with metal, plastic, or ceramic components. In hip resurfacing, the femoral head is not removed, but is instead trimmed and capped with a smooth metal covering. The damaged bone and cartilage within the socket is removed and replaced with a metal shell, just as in a traditional total hip replacement.
(Left) In the x-ray of a hip resurfacing taken from the front, a metal cap now covers the femoral head, and a small stem is seen in the femoral neck. A traditional total hip replacement is shown on the right, which illustrates the larger implants and the bigger amount of bone that is removed.
Ceramic on Ceramic Hip Resurfacing
Ceramic on Ceramic hip resurfacing is a new experimental hip procedure, designed to reduce the complications associated with traditional metal on metal hip resurfacing procedures. Ceramic hip resurfacing has been developed by Prof Cobb in the UK, Mike Tuke in the UK and others around the world. It does offer several potential advantages over traditional metal resurfacing, however, it is an untested and experimental procedure, and is currently only available in Australia as part of a trial due to the uncertainties around the potential complications which may arise from the introduction of new prosthesis.
If you would like to discuss ceramic resurfacing to treat your hip arthritis, please contact Dr Slattery at our Melbourne rooms.
Advantages of Hip Resurfacing
The advantages of hip resurfacing over traditional total hip replacements is an area of controversy among orthopaedic surgeons.
- Lower rate of failure: the Australian Joint Replacement Registry has shown that in certain patients Hip Resurfacings are lasting longer than some total hip replacements.
- Hip resurfacings may be easier to revise. Because the implants used in hip replacements and hip resurfacings are mechanical parts, they can wear out or loosen over time. If an implant wears out and requires exchange this is called a revision and it can be more complicated than the initial operation. Because hip resurfacing removes less bone from the femur (thighbone) than a traditional hip replacement, it is easier to exchange implants that fail after hip resurfacing.
- Decreased risk of hip dislocation. In hip resurfacing, the size of the ball is larger than in a traditional hip replacement, and it is closer to the size of the natural ball of your hip. Because of this, it is harder to dislocate.
- More normal walking pattern. Several studies have shown that walking patterns are more natural following hip resurfacing compared to traditional hip replacement.