Hip Resurfacing
Until recently, your orthopaedist would likely be recommending traditional hip replacement surgery when diagnosed with advanced hip arthritis. Although total hip replacement is more invasive to the bone than hip resurfacing, it is a safe and effective surgery, and is performed more than 300,000 times per year in the United States.
Hip resurfacing is an alternative to traditional hip replacement in which the femoral head (ball part of thigh bone) and acetabulum (hip socket) are resurfaced rather than replaced. Traditional hip replacement requires the removal of the femoral head and the insertion of a hip stem down the shaft of the femur. Hip resurfacing, on the other hand, preserves most of the femoral head and the femoral neck. During the procedure, your surgeon will only remove a few centimeters of bone around the femoral head, shaping it tightly inside the hip resurfacing implant.
Your surgeon will also prepare the acetabulum for the metal cup that will form the socket portion of the ball-and-socket joint. While the resurfacing component slides over the top of the femoral head and neck, the acetabular component is pressed into place much like a hip replacement would be.
Hip Resurfacing: Surgical Procedure
Hip resurfacing is technically more difficult and generally requires a larger incision than what is used for a conventional hip replacement.
The benefit of hip resurfacing is that its bone conserving - meaning more of your healthy bone is kept intact. The damaged area is simply resurfaced, not fully removed. In this innovative process, the end of the thigh bone (femur) is capped with a metal covering - a strong cobalt chromium metal. This fits neatly into a metal cup that sits in the hip socket.
Recovery after Hip Resurfacing
When you are medically stable, the physical therapist will recommend certain exercises for the affected joint. Physical therapy is a key part of recovery. The more quickly a joint replacement patient gets moving again, it is more likely that he or she will regain independence just as quickly. To ease the discomfort the activity will initially cause, pain medication is recommended prior to therapy.
The success of your joint replacement will strongly depend on how well you follow your orthopaedic surgeon's instructions. As time passes, you should experience a dramatic reduction in joint pain and a significant improvement in your ability to participate in daily activities.
Your physical therapist will also go over exercises to help improve your mobility and to start exercising the thigh and hip muscles. Ankle movements help pump swelling out of the leg and prevent the possibility of a blood clot. When you are stabilized, your physical therapist will help you up for a short outing using your crutches or walker.
Your physical therapist may use hands-on stretches for improving range of motion. Strength exercises address key muscle groups, including the buttock, hip, thigh and calf muscles. You can work on endurance through stationary biking, lap swimming and using an upper body ergometer (upper cycle). Physical therapists sometimes treat their patients in a pool. Exercising in a swimming pool puts less stress on your joints and the buoyancy lets you move and exercise easily.
When you are safe putting full weight through the leg, several types of balance exercises can help you further stabilize and control the hip or knee. Finally, you will work with a group of exercises to simulate day-to-day activities, such as going up and down steps, squatting, rising up on your toes, bending down and walking on uneven terrain. You may be given specific exercises to simulate your particular work or hobby demands.
Hip Resurfacing: Who is a Candidate?
Hip resurfacing is intended for young, active adults who are under 60 years of age and in need of a hip replacement. Adults over 60 who are living non-sedentary lifestyles may also be considered for this procedure. However, this can only be further determined by a review of your bone quality.
There are certain causes of hip arthritis that result in extreme deformity of either the head of the femur or the hip socket. These cases are usually not candidates for hip resurfacing.
