HIP RESURFACING: BENEFITS, RISKS AND COST

Just as traditional hip arthroplasty, this procedure can decrease your hip pain, improving your mobility and quality of life.

However, invasive procedures such as hip replacement surgery are the last option after using more conservative treatments, including medication and assistive walking devices.

But, unlike hip replacement, resurfacing surgery is not suitable for everyone.  Ideal candidates are typically younger (less than 60) and larger-framed patients with strong, healthy bone.

Conversely, older female patients with weaker or damaged bones are less than ideal and prone to complications, such as femoral neck fracture.

In the end, your doctor’s decision whether to replace or resurface your hip will come after a comprehensive evaluation. It will depend on your age, weight, size, and any conditions that might make your bone softer than expected.

Hence, hip resurfacing surgery is not recommended in patients with:

• Osteoporosis
• Rheumatoid arthritis
• Areas of dead bone in their femoral head (avascular necrosis)
• Neck cysts close to the head-neck junction

These conditions are a synonym of soft, fragile bone and poor blood supply.

Additionally, metal-on-metal resurfacing systems are not recommended for patients with metal hypersensitivities and women of child-bearing age due to possible unknown effects of metal ion release.

The main disadvantage of hip resurfacing surgery is a femoral neck fracture. So, appropriate patient selection is key when choosing this procedure. This can happen in a small percentage of patients (0–4%). If this occurs, you may need a traditional hip replacement.

A femoral neck fracture is not a complication with a traditional hip arthroplasty because the femoral neck is cut and removed. However, small fractures around the prosthesis can occur with a traditional hip replacement.

There have been some concerns due to cases of metal-on-metal (MoM) hip replacements wearing out earlier than expected or causing damage to the soft tissues around the hip.

For this reason, hip resurfacing systems are used less frequently. Also, the metal-on-metal constant friction produces metal debris, releasing metal (cobalt and chromium) to the bloodstream.

However, some companies have been working on novel components. They use a ceramic coating on the metal femoral head and cross-linked polyethylene plastic for the socket.

Finally, another limitation is that hip resurfacing surgery is a more complex procedure to perform. Also, proper positioning of main components is essential, and a larger incision is usually required.

In most cases, hospital stay goes between 1 to 4 days. Depending on your doctor’s preferences, you may be encouraged to start putting weight on your leg immediately after surgery. But, you may need a cane, walker, or crutches during the first few days or weeks until you can walk without assistance.

You can expect pain and discomfort for several weeks after surgery. However, you will be prescribed pain killers and other medications if needed.

The physical therapist will be your best friend from now on. He will give you exercises to slowly restore your strength and improve your range of motion.

Also, you will have regular follow-up check-ups with your orthopaedic surgeon to monitor your progress. You will probably be able to resume most of your everyday activities within six weeks of the surgery. However, your recovery will last between four to six months.

Bear in mind that the main components of your hip resurfacing system may wear out sooner than expected or loosen over time. So, you may need revision surgery approximately 10 to 20 years after your original hip surgery.

Risks of hip resurfacing surgery include those common of a traditional hip replacement, including infection, blood clots, neck fracture, and dislocation (very rare).

To prevent infections, you will be given antibiotics before and after surgery. And for blood clots, you will have to wear compression stockings and receive blood thinners.