Total hip resurfacing is a procedure that may be performed to treat patients who are suffering from advanced arthritis in the hip. It involves a trimming and covering of the femoral head, which is the end of the thigh bone that sits in the hip joint. Any damaged cartilage or bone in the joint is removed and metal implants are inserted over the ball and in the socket. The procedure is similar to that of a hip replacement surgery, but in a total hip resurfacing, the femoral head and socket are not removed.
Good candidates for total hip resurfacing are typically patients who have developed severe damage in the hip due to arthritis. These individuals have usually tried more conservative forms of treatment but obtained little relief of their symptoms. Total hip resurfacing is frequently most successful in patients under the age of 60 with larger-sized frame structures and healthy, dense bones. Those patients who do not meet these criteria may be evaluated to determine whether they are eligible for the procedure, but are often at an increased risk of complications.
There are several reasons why total hip resurfacing may be the procedure recommended by a surgeon for certain patients. The benefits of undergoing a total hip resurfacing procedure rather than a hip replacement often include:
While total hip resurfacing can be a very effective form of treatment, it is not the right procedure for every patient. It can be a more challenging type of surgery to perform than a hip replacement, and often necessitates the use of a larger incision. Total hip resurfacing also puts the patient at risk for developing a fracture toward the top of the thighbone in the femoral neck. Since the femoral neck is removed during a replacement surgery, this is not a risk related to that procedure. Additionally, some patients have an allergic reaction to the metal ion particles produced during movement of the hip after total hip resurfacing surgery.
The total hip resurfacing surgery is performed with the patient under anesthesia. The procedure generally takes between one-and-a-half and three hours. After an incision is made in the thigh, the surgeon will ease the femoral head out of the socket. Tools are used to reshape the head before a metal covering is placed on top of it. The cartilage of the hip socket is removed and a rounded metal implant is inserted in its place. Once this implant has been positioned correctly, the femoral head is reinserted into the socket. The incision will then be sutured closed.
Total hip resurfacing is an inpatient procedure, with patients typically requiring a hospital stay of one to three nights. Many patients require the use of an assistive device such as crutches or a walker temporarily after the surgery. Physical therapy can be very beneficial in promoting flexibility, strength and maximizing a patient’s range of motion in the hip joint. Most patients will be ready to return to normal daily activities approximately six weeks following the procedure.
While total hip resurfacing is considered a generally safe procedure, all forms of surgery carry some risk. The risks that may be associated with total hip resurfacing include infection, development of blood clots, femoral neck fracture, hip dislocation, damage to nerves or blood vessels and reactions to anesthesia.