Hip resurfacing is a surgical procedure in which part of the hip joint is removed and capped with a prosthetic metal joint. The prosthetic joint functions very similar to a normal ball and socket hip joint. Hip resurfacing is a good alternative to a total hip replacement in younger patients, since they are likely to need another hip replacement at some point in life.
Many patients with arthritis and other hip problems can be helped by hip resurfacing. The hip replacement prevents the femur and pelvic bones from rubbing against each other, which can cause pain. The prosthetic joint can also help patients move more easily and achieve better range of motion than what they had prior to the surgery.
Prior to the surgery, most patients undergo a thorough physical examination. This helps the doctors record the patient's current health and pain levels. Most patients practice some of the exercises they will be doing during rehabilitation before surgery. Patients may also learn how to use crutches or a walker and donate some of their own blood three to five weeks before the procedure in case they need a blood transfusion during surgery.
Hip resurfacing is performed under general anesthesia, which means the patient is asleep. Some surgeons open the front of the hip, while others place the prosthetic joint through an incision in the back of the hip. The surgeon dislocates the femur from the hip socket and shaves away some of the bone on the head of the femur to shape the bone so that the metal cap will fit securely over it. He or she then places a round metal cap over the head of the femur.
In some hip resurfacing procedures, the surgeon leaves the hip joint socket as it is. In most cases, however, the surgeon removes some of the cartilage in the hip socket so that he or she can fit a metal cup over it. The surgeon then fits the femur back into place so that the metal cap on the tip fits inside the metal cup in the socket.
Complications from hip resurfacing surgery are not likely when performed by a trained surgeon and when the patient follows all of the surgeon's instructions. Some of the more common complications include a reaction to the anesthesia, infection of the surgical site, dislocation or loosening of the new hip joint, and thrombophlebitis, which are blood clots that form in the legs. It is important for patients to let their doctors know about any allergies, health conditions, or previous reactions to anesthesia that they may have had.
Most patients spend two to four days in the hospital after hip surgery. They must take good care of the incision according to the surgeon's instructions by keeping the wound clean and covered to prevent infection. The staples that close the incision are typically removed about two weeks after the procedure. Patients usually wear compression stockings after surgery to prevent blood clots and walk with crutches or a walker for about six weeks.
After hip resurfacing surgery, patients usually attend physical therapy sessions several times a week for three months or more. Physical therapy consists of exercises to strengthen the hip and improve the range of motion. Exercises are often done in water to put less pressure on the hip joint. Patients follow up with home exercises to keep the joint healthy and strong.
While hip resurfacing provides a good alternative to a total hip replacement in many patients, it is not recommended for people who have osteoporosis, diabetes, kidney problems, and allergies or sensitivities to metal. Patients with osteoporosis and other degenerative diseases may be at a greater risk for dislocation after hip resurfacing, which could result in serious injury or the need for an additional surgery to fix the problem.
