Hip resurfacing is a less common procedure that is indicated mainly for younger people suffering from severe hip osteoarthritis. Advantages of this procedure over a total hip replacement are that there is greater bone conservation, making it in theory easier to revise to a total hip replacement in the future.
The surgery involves first trimming the bone on the surface of the ball of the femur (femoral head), as well as preparing the hip socket (acetabulum). After this, a metal liner is placed over top of the femoral head and a matching hip socket prosthesis is placed into the acetabulum (figure 1). This replaces the cartilage and bony articulating surfaces with metal components that can glide more smoothly over each other.
The procedure is more technically challenging that a total hip replacement, and a successful outcome largely depends on the demographics of the person undergoing the procedure. In general, young active males with good quality bone are more likely to achieve successful outcomes with hip resurfacing.
Figure 1: Hip resurfacing
Recovery from hip resurfacing is similar to total hip replacement. Pain medications may be needed during the initial recovery period. Weight bearing can be initiated soon after surgery, and gradually increased as directed by the surgeon. Physical therapy and use of an assistive device such as crutches or a cane can speed recovery and help individuals return to their previous level of activity.
Potential complications of hip resurfacing include:
- Deep vein thrombosis
- Pulmonary embolism
- Prosthetic wear causing metal ion release- This can result in local inflammation and whole body (systemic) effects
- Surgical site infection
- Prosthetic loosening -This can occur over time and may lead to failure of the prosthesis and the need to convert the hip resurfacing to a total hip replacement.