What is Hip Resurfacing?

There are several surgical approaches to hip replacement surgery, including minimally invasive options depending on the appropriateness to the patients. Hip resurfacing is one specific type of hip replacement surgery. In a total hip replacement, the head of the femur (femoral head) and the damaged socket (acetabulum) are both detached and substituted with artificial implants such as metal, plastic, or ceramic components. Contrarily, hip resurfacing involves the removal of the femoral head alone, it is trimmed of all the damaged portions and capped with a smooth metal covering. The damaged bone and cartilage within the socket are also removed and replaced with a metal shell, just as in a traditional total hip replacement. This means the femoral head has a small part or very little bone removed that is replaced with the metal component and spares the femoral canal. Thus, it is an alternative to total hip replacement surgery. The choice to have a traditional hip replacement or a hip resurfacing procedure is complex, and your surgeon will decide your suitability based on many factors.

Who are eligible for Hip Resurfacing?

Your surgeon may recommend surgery if you are suffering from severe hip hurt. It will be suggested when your quality of life is affected and the symptoms have not been relieved even after conservative treatment options such as medications, injections, and physical therapy. Ideally, younger and larger-framed patients with the healthy bone are more suitable candidates for surgery. On the other hand, it is not recommended for patients with known metal hypersensitivities, osteoporosis, impaired kidney function, and large areas of dead bone (avascular necrosis).

Some conditions that damage the hip joint make the hip surgeries necessary are listed below.

• Rheumatoid arthritis: This condition is caused by an overactive immune system, and produces severe inflammation that can erode cartilage and even underlying bone sometimes. This can result in damaged and deformed joints.
• Osteoarthritis.: It is also known as wear-and-tear arthritis, damaging the slick cartilage covering the ends of bones and helping joints move smoothly.
• Osteonecrosis: For some people, dislocation or fracture can result in less blood supply to the ball portion of the hip joint such conditions can result in bone collapse or deformities injuring the total hip joint.

Tests and Diagnosis for Hip Resurfacing

Diagnosis is made by evaluating your symptoms, diseases or disorders, medical history, physical examination, and X-rays. Additionally, imaging tests such as MRI and CT scans may be needed to confirm the diagnosis. Before your surgical procedure, the Anesthetist will evaluate you, review your medical history and discuss anesthesia choices with you.

Surgical Procedure

The procedure takes under two hours. Your surgeon will make an incision in the thigh to access the hip joint. The damaged bone will be trimmed and also the damaged cartilage from the thighbone head (ball) will be removed. The surgeon will use surgical cement to attach a smooth metal cap to the ball. Any damaged bone and cartilage from the hip socket will also be removed. The surgeon will then push a metal shell into the hip socket. The socket has a roughened back which attaches itself to the bone of the pelvis. The femoral head (ball) into the hip socket is gently moved back and the incision is closed with stitches. You will have to spend a day or two in the hospital. You may need to use support like crutches, a walker, or a cane for a few weeks for 6-8weeks.

Post-operative precautions after Hip Resurfacing

After the surgery, you must take care to ensure proper healing and prevent another dislocation. Physical rehabilitation is a critical component of recovery. Your surgeon will recommend specific exercises or direct you to a therapist to help increase your range of motion and restore your strength. Some of the crucial precautions for 6 weeks are listed below.

• Continue the prescribed exercises 3 or 4 times a day for 6 weeks
• Stay active, gradually increasing your walk each day
• Avoid bending your hip beyond 90 degrees
• Avoid rolling your leg towards the other leg or crossing your legs
• Avoid twisting your hip when standing
• Use the shower instead of the bath
• Keep using your crutches or walking till you feel comfortable
• Don’t fly for at least 3 months. Use an elevated toilet seat
• Avoid sitting on low chairs
• Keep a pillow between your legs while sleeping.
• Avoid bending down to pick up things
• Avoid combined movement of bending your hip and turning your foot inwards

What are the risks & complications?

As any surgery has a risk component, a few of the complications are listed below.

• Femoral neck fracture.
• Metal ion risk from artificial metal implants
• Dislocations
• Infections
• Blood clots
• Nerve and artery injuries
• Delayed wound healing
• Fracture of the femur
• Differences in leg length

What are the Advantages of Hip Resurfacing surgery?

As this procedure restores the natural size and shape of your hip, compared to a hip replacement, it gives better stability, reduced risk of dislocation, a broad range of movement, higher levels of activity, and an easy revision, if a second surgery is required in the future.