Hip resurfacing is a type of hip replacement where damaged bone and cartilage is trimmed from the hip ball and socket. Then, the orthopedic surgeon places a smooth metal cap on the top of the remaining head of the femur and metal shell goes into the hip socket.
The biggest difference between hip resurfacing and a traditional total hip replacement is the surgeon doesn’t remove the head of the femur. Overall, hip resurfacing decreases the amount of bone removed. Only specific patients are candidates. You must be age 55 or younger with a BMI under 35 and lead an active lifestyle.
Advanced orthopedic surgical training needed
The surgery is technically more demanding. The majority of the patient population doesn’t qualify so the procedure is not as common. “Surgeons must be specially trained to perform the surgery which requires great skill, so most surgeons are not able or comfortable doing hip resurfacing,” said Dr. David Simenstad, orthopedic surgeon at Marshfield Clinic Health System.
A surgeon will look at bone strength and structure when considering if a patient should have the surgery. Generally, men predominately qualify the most because their bone size is larger. Companies who produce the metal implants used in the surgery make only larger sizes. This doesn’t exclude women entirely. If their bone structure aligns with implant sizing they can opt for resurfacing, too.
The surgery time is comparable. However, because of a larger incision with resurfacing, initially patients may have increased pain during recovery. However, long-term recovery is usually a faster process by about six weeks. Most patients are back into their daily activities between six weeks and three months with no restrictions.
Hip resurfacing good fit for active lifestyles
In traditional hip replacements, high-impact activities are discouraged because they can loosen the artificial joints and increase risk of long-term wear issues. In comparison, people who undergo hip resurfacing can get back to normal activities after they heal with improved mobility.
“Hip resurfacing is optimal for younger patients because it does not have activity restrictions after surgery,” Dr. Simenstad said. “Patients with hip resurfacing can do heavy labor and other really vigorous activity that you can’t do after a total joint replacement.”
Failure rate at 10 years is the same to a traditional total hip replacement. It is quite low for both at about 3%. “We don’t know how many years beyond 20 years either will last” Dr. Simenstad said. “However, patients who had their hip resurfaced are generally putting a lot more stress on the joint due to their active lifestyle.”
The good news is if a hip revision is needed, it is relatively easy to convert a hip resurfacing to a traditional total hip replacement where as a failed total hip revision is frequently much more difficult.
If you think hip resurfacing is right for you, talk with your provider who can recommend an orthopedic surgeon who performs this surgery.