Hip resurfacing is a type of hip replacement surgery where the surface of the femoral head (the ball of the hip joint) is capped with a smooth metal covering, and the damaged bone and cartilage within the hip socket are replaced with a metal shell. This procedure is considered an alternative to total hip replacement, particularly in younger, more active patients who wish to preserve more of their natural bone.

Hip resurfacing may be considered for individuals with:

• Osteoarthritis: Severe degeneration of the hip joint due to wear and tear.
• Rheumatoid Arthritis: Chronic inflammatory condition affecting the hip.
• Avascular Necrosis: Death of bone tissue due to a lack of blood supply.
• Dysplasia: Abnormal development of the hip joint.

Advantages

• Bone Preservation: Hip resurfacing preserves more of the femoral bone compared to total hip replacement.
• Lower Dislocation Risk: The larger size of the resurfaced femoral head can reduce the risk of hip dislocation.
• Activity Level: Suitable for younger, more active patients as it may allow for a greater range of motion and return to higher levels of physical activity.

Disadvantages

• Not Suitable for Everyone: Not recommended for patients with poor bone quality, such as those with osteoporosis, or those with significant femoral head deformity.

Procedure

• Incision and Exposure: An incision is made to expose the hip joint.
• Preparation of the Femoral Head: The damaged surface of the femoral head is trimmed and shaped to fit the metal cap.
• Capping the Femoral Head: A metal cap is placed over the prepared femoral head.
• Acetabular Component: The damaged cartilage and bone from the hip socket (acetabulum) are removed and replaced with a metal shell.
• Final Adjustment: The hip joint is checked for stability, and the components are adjusted as necessary.

Recovery

• Hospital Stay: Typically, patients stay in the hospital for a few days post-surgery.
• Weight-Bearing: Early weight-bearing is encouraged, but patients usually need crutches or a walker for a few weeks.
• Physical Therapy: A structured rehabilitation program is essential to regain strength and mobility.
• Activity: Patients can often return to low-impact activities within a few months, but high-impact sports may require longer.

Long-Term Outlook

• Durability: Hip resurfacing implants have a lifespan similar to that of total hip replacements, but outcomes depend on factors such as patient activity level and bone quality.
• Revision Surgery: In some cases, patients may eventually need a revision to a total hip replacement if the resurfacing implant fails or complications arise.

Conclusions

Hip resurfacing is a viable option for certain patients, particularly younger, active individuals who want to maintain a higher level of activity post-surgery. It offers the benefits of bone preservation and potentially lower dislocation rates but comes with specific risks related to metal-on-metal implants. A thorough discussion with an orthopedic surgeon is crucial to determine if hip resurfacing is the best option based on individual needs and health status.