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Hip Resurfacing Surgery

How is hip resurfacing surgery performed?

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Updated April 16, 2014

Hip resurfacing surgery is performed through an incision similar to a standard hip replacement. The arthritic joint is exposed, and the remaining cartilage is removed, but most of the bone stays in place. A metal cap is then placed on the ball, and a metal socket is placed in the pelvis.

What are the possible complications of hip resurfacing surgery?
There are a few major concerns with hip resurfacing surgery, and unfortunately, no one knows the long-term results of the implants that are currently being used. Therefore, no one can definitavely say that this surgery is better or wosre than a standard hip replacement. The current implants used in hip resurfacing have only been used for about 10 years, and the only data available is on so-called short-term (less than 1 year) and mid-term (1 to 10 years) follow-up. No long-term data are available for hip resurfacing surgery.

Possible complications include:

  • Fracture
    The risk of fracture of the bone supporting the hip resurfacing implant has led some doctors to question if this surgery should be done on any patients. While studies have varied, the risk of fracture of the bone seems to be between 1% and 20% of patients. Fractures are more common in pateints who have poor bone quality, obese patients, and women. In addition, fractures are more common for surgeons who have done this surgery less frequently.

  • Loosening
    Similar to standard hip replacements, hip resurfacing implants can become loose over time. If the implant loosens, a standard hip replacement usually needs to be performed.

  • Metal Ions
    All implants inserted into the body slowly wear out over time. Metal implants used in hip resurfacing surgery have been shown to wear less than plastic implants, but the metal implants do release metal ions into the body as they wear. These metal ions can be detected throughout the body in patients who have had metal-on-metal hip replacements or hip resurfacing surgery.

    The effect of these metal ions in the body is not known. There are concerns about causing hypersensitivity reactions and possible carcinogenic (cancer causing) effects. Fortunatley, there is little data to show this is a problem, but it is a theoretic concern.

What is the recovery from hip resurfacing surgery?
The recovery following hip resurfacing surgery is similar to that following hip replacement surgery. Patient have a lower risk of dislocation of the implants, so the precautions placed on the patient may be less significant.

During the first year after surgery, all impact activities and heavy lifting must be avoided. This is the time frame when the bone holding the implant is most susciptible to fracture. Therefore, current recommendations are to avoid running, jumping, and lifting for the first 12 months after surgery.

Will I need more surgery at a later date?
It is not known how long on average hip resurfacing implants will last. With better designed implants, they seem to be functioning well at the 10 year mark. However, that is still not as good as what is known about standard hip replacements.

If the hip resurfacing implant does develop problems, or if it does wear out, additional surgery may be recommended. Because the initial hip resurfacing surgery removed less bone than a standard hip replacement, the revision (repeat) surgery is usually less complicated following a hip resurfacing procedure. The usual procedure is to convert the worn out hip resurfacing implant to a standard hip replacement.

Who can I contact to find out more about hip resurfacing surgery?
The most commonly used implant for hip resurfacing in the United States is called the Birmingham Hip Resurfacing implant or BHR Hip. You can find information about this implant, and surgeons who perform this procedure by going to their website at:

  • BHR Hip

    Other companies are also designing and testing hip resurfacing implants, so more options will be available in coming years.

    Sources:

    1. About.com
    2. Health
    3. Orthopedics
    4. Hip & Knee
    5. Hip & Knee Replacement
    6. Hip Replacement Surgery
    7. Information on Hip Resurfacing Surgery

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