Hip Resurfacing
Indications for Hip Resurfacing
Hip arthritis leads to pain and disability. There is no cure for the missing or damaged cartilage. Nonsurgical treatments are meant to decrease pain and or to allow someone to do more of their normal activities. They are short term methods and are not meant to cure the problem. Surgical treatment is a more permanent treatment.
Hip resurfacing is done for hip arthritis that is interfering with a person’s ability to do their normal activities.
Candidates for Surgery
Men younger than 70 and women under 55 may be candidates for Hip Resurfacing – a surgical treatment offered to younger and more active patients. Older patients may be eligible for hip replacement.
Hip Resurfacing Procedure
In hip resurfacing, the femoral head is not removed, but is instead trimmed and capped with a metal or ceramic “cap”. The damaged bone and cartilage within the socket is machined and replaced with a metal or polyethylene or ceramic shell. Most of the current hip resurfacing devices are metal on metal. New ones are becoming available which use other materials.
Read a patient testimonial to discover the journey from consultation through to recovery.
Why choose Hip Resurfacing Arthroplasty?
Function & Activities
Hip resurfacing creates the most normal functioning artificial hip joint possible.
This is especially important for active people who want to return to more aggressive activities or people engaged in physical work.
Many studies report improved functional results after hip resurfacing compared to total hip replacement.
Bone Preservation
In hip resurfacing, the femoral head is preserved, and no stem is put into the upper end of the femur leaving this bone available for when and if a revision is needed. A hip resurfacing does not prevent one from having a hip replacement later.
The biomechanics of the hip are closer to normal after hip resurfacing and the bone quality in the upper femur improve after hip resurfacing. The bone quality in the upper femur deteriorates after hip replacement and never returns to normal.
When a revision surgery is needed, much more of the femur is available for the next procedure. On the femoral side, the revision is just like doing a total hip for the first time. When a Total Hip Replacement stem fails, revision involves inserting a larger and longer stem into the femur farther removing more bone.
Mortality
Studies have shown that patients who have undergone hip resurfacing are more likely to be alive 10 years later compared to patients who have had a hip replacement.
Activities after Hip Resurfacing
Hip Resurfacing patients have no restrictions on their activities after recovery, usually considered 6 months. Many patients are able to return to running. The risk of dislocation is extremely low since the femoral implant is usually very close to the same size as the original.
Traumatic injuries such as a broken femur are much easier to treat when a hip resurfacing is present compared to when a hip replacement is present.
Many studies report a more normal gait pattern in walking after hip resurfacing compared to hip replacement.
This return to normal life and full activities with no restrictions is one of the main reasons to consider hip resurfacing rather than hip replacement.
- Normal hip mechanics: The ball-in-socket part of a resurfaced hip is very similar in size and articulation to a normal hip. This allows the hip to behave in a biomechanically normal way, very similar to a normal healthy hip joint.
- Greater stability than a total hip replacement: meaning there is a decreased risk of hip dislocation. In hip resurfacing, the size of the ball is larger than in a traditional hip replacement. It is closer to the size of the natural ball of your hip. Because of this, it may be harder to dislocate.
Learn More
- Smith & Nephew Birmingham Hip Resurfacing
- Surface Hippy
- Rediscover Your Go
- Hip Resurfacing Video
- Preliminary report of clinical experience with metal-on-highly-crosslinked-polyethylene hip resurfacing
- Hip resurfacing arthroplasty in young patients: international high-volume centres’ report on the outcome of 11,382 metal-on-metal hip resurfacing arthroplasties in patients ⩽50 years at surgery
Hip Resurfacing for Females
Hip Resurfacing is a very good option for younger and more active male patients, however is generally contraindicated in females. In some large registry data series of cases, it has been identified that failure rate of resurfacing is higher in ladies than it is in men. In some series the number of failures is greater than 10 % at 10 years. Some health care systems use 10 % at 10 years as a cut-off for what is considered the minimum achievable to allow a product or procedure to be used. In some surgeons own series, these numbers are better, but these are surgeons with very high volumes of hip resurfacing.
The reason for the increased failure rate in women is complex and involves a few factors. Smaller-sized implants tend to have worse results than larger sizes. Women tend to have smaller sizes of femoral head and therefore smaller implant sizes. They are more at risk for femoral neck fracture due to decreased bone density. Women appear to have a greater incidence of reaction to the microscopic metal debris generated by metal on metal hip resurfacing devices. This is presumed to be due to increased exposure to various metals for women with piercings that may sensitize ladies to nickel which is present in very small quantities in the implants.
For the past 8 years this procedure has been relatively contraindicated in females due to a higher failure rate in females.
Polymotion® Hip Resurfacing
Now, a new implant is available which eliminates the concerns of the Metal-on-Metal hip resurfacing devices. This new implant is metal-on-plastic (like a total hip) and holds great promise for females interested in the potential advantages of a hip resurfacing device over a total hip replacement. This implant takes advantage of the technologic improvements in plastic manufacturing to improve the wear characteristics of the plastics used. Thus, allowing hip resurfacing to be available without the concerns of the bearing producing microscopic metallic debris.
Only very limited and short-term data is available for this new implant. The new implant is based on several proven technologic advances and some clinically similar implants. The femoral component shares many design features with the existing metal on metal resurfacing devices. The socket uses advances in plastic technology to create a plastic that is very resistant to wear. A proven titanium backing on this plastic cup allows bone to integrate into this cup very predictably.
Only a very small number of surgeons have access to this implant today.
It is definitely new, unproven, and technologically investigational. It has the potential to allow women to access the benefits of hip resurfacing: improved function, bone preservation, biomechanical advantages, and lower mortality without the drawback of a metal-on-metal articulation.
*Please note, the Polymotion® Hip Resurfacing device is not licensed in accordance with Canadian Law.