Hip resurfacing is a surgical procedure that involves reshaping and capping the diseased or damaged hip joint with a metal prosthesis. It is an alternative to total hip replacement (THR) and is specifically suitable for younger, active patients who have good bone quality and wish to maintain a high level of physical activity. In hip resurfacing, the goal is to preserve more of the patient's natural bone compared to a traditional total hip replacement.
During a hip resurfacing surgery, the patient is placed under general anesthesia. An incision is made to access the hip joint. Unlike THR, where the head of the femur is completely removed, in hip resurfacing, the femoral head is preserved. The damaged surface of the femoral head is reshaped to fit a metal cap, which is made of cobalt-chromium alloy and is designed to mimic the shape of the natural femoral head. The metal cap is then fixed in place with bone cement or a press-fit technique.
In the acetabulum (the socket), the damaged cartilage is removed, and the socket is prepared to receive a metal cup. The metal cup is also made of cobalt-chromium alloy and is implanted into the socket, creating a new bearing surface. The metal-on-metal articulation allows for smooth movement and low wear.
One of the advantages of hip resurfacing is that it allows for a larger femoral head size, which can potentially enhance stability and range of motion. It also provides the opportunity for future revision surgery if needed since more bone is preserved compared to THR. Additionally, hip resurfacing may result in a more natural feeling and improved function for some patients, as the procedure maintains the patient's native femoral head.
Following surgery, patients typically stay in the hospital for a few days. Pain management medications and antibiotics are administered to ensure comfort and reduce the risk of infection. Physical therapy and rehabilitation play a crucial role in the recovery process, helping patients regain strength, flexibility, and mobility in the hip joint.
However, hip resurfacing is not suitable for everyone. It is generally not recommended for patients with significant osteoporosis, reduced bone quality, or certain conditions that increase the risk of implant failure. Additionally, there have been concerns regarding metal-on-metal implants, as they may release metal ions into the bloodstream, leading to complications such as metallosis and adverse tissue reactions. Therefore, careful patient selection, proper surgical technique, and regular monitoring of metal ion levels are essential.
As with any surgical procedure, there are risks associated with hip resurfacing, including infection, blood clots, dislocation, fracture, and implant failure. Patients should discuss these risks with their surgeon and thoroughly understand the potential benefits and drawbacks of the procedure.
In conclusion, hip resurfacing is a surgical procedure that reshapes and caps the damaged hip joint with a metal prosthesis. It is an alternative to total hip replacement, primarily suitable for younger, active patients with good bone quality. Hip resurfacing aims to preserve more of the patient's natural bone and provides the potential for future revision surgery if needed. While it offers certain advantages, careful patient selection and monitoring are crucial, as there are associated risks and concerns related to metal-on-metal implants. Patients should consult with their orthopedic surgeon to determine if hip resurfacing is the right treatment option for their specific condition.