Any hip surgery should be the last resort after trying other nonsurgical options. It should only be considered if your hip problems are having a very negative effect on your quality of life.
Although hip resurfacing may have many benefits, it is not for everyone. Resurfacing works best on patients who:
- Have larger frames (usually male)
- Are younger than 60
- Have strong, healthy bone
Patients who have a smaller frame, are older, are female, or who have weaker bones are not good candidates for resurfacing and are more at risk of negative side effects. The disadvantages of resurfacing for all patients includes:
- A few patients eventually break the thigh bone just below its head. When this happens, you must have a second surgery to do a traditional hip replacement.
- When a hip replacement must be revised, the surgeries are more difficult and usually do not have results as good as the first surgery.
- Over time, the rubbing of the metal ball against the metal socket can wear down and release metal ions in the blood. These can be dangerous if they reach high levels. The socket in a traditional hip replacement is usually plastic, and the metal ball doesn’t wear on it and release the metal ions.
- Compared to resurfacing, hip replacement surgery usually lasts longer. Total hip replacement is often done later in life. The life of the components (20 years or longer) then better matches the life span of the patient.
- Hip resurfacing is a more difficult surgery than total hip replacement. Because of this, patients should make sure they trust their potential surgeon and their experience for the best possible results.
Complications of Surgery
Although complications are rare, the most common potential issues are:
- Infection: The surgeon will give you antibiotics before your procedure to help fight off infection.
- Blood clots: Blood clots are the most common complication of hip resurfacing surgery. They can form in the deep veins of the pelvis of the legs. Your doctor may give you blood-thinning medicine to help prevent blood clots from forming.
- Hip dislocation
- Femoral neck fracture
- Possible risks from anesthesia
- Nerves or blood vessels could possibly be injured during the procedure
Orthopedic surgeons do not agree on the benefits of hip resurfacing. They are still studying it. The benefits include:
- Although the hip resurfacing surgery requires a larger incision than traditional hip replacement, it usually has a faster recovery because less bone is removed. Patients are up and walking within a couple of days and discharged quicker from the hospital.
- Hip resurfacings are mechanical parts that wear out over time, usually between 10 and 20 years after the procedure. If your hip implant fails, you may need another procedure called a revision. But since hip resurfacing removes less bone than a traditional hip replacement, many surgeons think it is easier to change out implants that fail.
- Some studies have shown that walking patterns are more normal after hip resurfacing compared to traditional hip replacement.
- It is usually harder for a patient who’s had hip resurfacing to dislocate their hip, since the size of the ball is larger than in a traditional hip replacement.
Before your surgery, ask your surgeon how much time you should plan to take off work. Make plans for someone to drive you home from the hospital and stay with you during your recovery.
Your surgeon will give you instructions on how to prepare for the surgery. An anesthesiologist [ann-ess-TEE-see-AH-loh-JIST] will review your medical history and go over the anesthesia choices you made with the surgeon. Your surgeon will also see you before surgery and verify the details of the procedure.
The surgeon makes an incision (cut) in your thigh at the hip joint. The femoral head is taken out of the socket, and then it is trimmed using special power tools. A metal cap is cemented on top of the femoral bone.
The surgeon then removes the cartilage that lines the socket and pushes a metal cup into the spot. It will be held in place by friction between the bone and metal. The femoral head is relocated back into the socket, and the surgeon closes and stitches up the incision.
After your operation, you will be taken to a recovery room and watched by nurses as you come out of anesthesia. Most people leave the hospital after 1 to 4 days.
It will take time to heal and regain strength in your leg muscles. However, many people can get back to their regular activity level about 6 weeks after surgery.
Most patients can go home 1-4 days after surgery. Your doctor may instruct you to start walking and putting weight on the leg right away, but you may also need a walker, crutches, or a cane at first.
You will continue to have follow-up visits with your surgeon regularly. You will also meet with a physical therapist, who will give you exercises that help restore your strength and range of motion.
The hip is a joint with a ball and socket. The top of the thigh bone (femoral head) is a smooth, rounded surface that fits into the hip socket (acetabulum). The bones are covered with smooth cartilage that lets them glide against each other when you move.
It’s common for this joint to experience wear and tear as you get older, especially if you develop arthritis as you age. Osteoarthritis is a kind of arthritis that happens at the ends of the bones. It breaks down cartilage, causing swelling, pain, and deformity.
Hip replacement surgery is for people with serious hip damage, such as advanced arthritis of the hip. If hip pain is having a serious negative impact on your ability to get around and enjoy life, you may talk to your doctor about hip replacement. During any hip replacement operation, the surgeon removes the damaged bone and cartilage from your hip and replaces them with man-made parts.
In a traditional total hip replacement, the surgeon removes the head of the thigh bone and the damaged hip socket. These bones are then replaced with a new head and socket. The head is usually metal and the socket hard plastic.
In a hip resurfacing procedure, the femoral head is left in place but is trimmed down and covered with a smooth metal piece. Any damaged bone and cartilage within the hip socket is also removed and replaced with a metal socket.
A hip replacement can help your hip work better, relieve your pain, and improve walking and motion of your leg. Your doctor will help you understand your options and which surgery is best for your situation.