Hip Resurfacing
Hip resurfacing is a bone-conserving alternative to traditional hip replacement. Unlike hip replacement, hip resurfacing doesn't replace the "ball" of the hip (femoral head) with a metal or ceramic ball. Instead, the damaged hip ball is resurfaced or reshaped and capped with a metal prosthesis. The damaged hip socket (acetabulum) is fitted with a metal shell — similar to what is used in a conventional hip replacement. The benefit of the procedure is that it is bone-conserving – meaning more of your healthy bone is kept intact as the ball and socket are simply resurfaced rather than replaced.
Surgical Procedure:
In this innovative process, special instruments are used to shapethe bone of the femoral head (ball) by removing just a few centimeters of bone. Once completed, it is capped with a new metal surface that sits snugly on top of the bone. The cap is held in place with a small peg that fits down into the bone, so it is important that the patient has enough healthy bone to support the cap. The hip socket is replaced with a thin metal cup. The surgeon will prepare the acetabulum (socket) for the metal cup by removing the cartilage from the acetabulum and shaping the socket to fit the acetabular component. Once the shape is correct, the acetabular component is pressed into place in the socket. Friction holds the metal liner in place until bone grows into the holes in the surface and attaches the metal to the bone. Hip resurfacing is technically more difficult and generally requires a larger incision than what is used for a conventional hip replacement.
Recovery:
Physical therapy is a key part of recovery for a hip resurfacing procedure. The sooner the patient gets moving again, the more quickly he or she will regain independence. When the patient is medically stable, a physical therapist will help the patient up for short walks using crutches or a walker. The patient will work on exercises focused on key muscle groups, including the buttock, hip, thigh and calf muscles. Ankle exercises are used to help pump swelling out of the leg and prevent the possibility of a blood clot. The physical therapist may also use hands-on stretches for improving range of motion and suggest stationary biking, lap swimming and using an upper body ergometer (upper cycle) to help build endurance. Exercising in a swimming pool may also be recommended as it puts less stress on the joints and the buoyancy lets the patient move and exercise easily. When the patient can safely put their full weight on the leg, several types of balance exercises will be incorporated to help further stabilize and control the hip or knee. Finally, the patient will progress to a group of exercises that 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. Specific exercises to simulate the patient’s particular work or hobby demands are also performed. To ease the discomfort the activity will initially cause, pain medication is recommended prior to therapy.
Who is a Candidate?
Hip resurfacing is intended for young, active adults who are under 60 years of age and who are 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.
