American Surgeons Slow to Embrace Hip ResurfacingJoint resurfacing is a logical way to reduce pain and restore function in young, active patients with severe arthritic changes of the hip. Hip resurfacing arthroplasty is a type of hip replacement that smooths the surface. Then a protective or replacement metal cap is placed over the bone at the top of the femur (thigh bone).
There are many advantages to this treatment. It preserves the bone. It restores the leg length. It can even give the patient improved biomechanics. If the replacement cap wears down, there's still enough bone left to change over or convert later to a total hip replacement.
American orthopedic surgeons haven't been as quick as surgeons in Europe to use this treatment method. There are reasons for this delay. Femoral neck fractures and osteonecrosis (death of bone) are two problems that occur with hip joint resurfacing.
There are also concerns about high metal ion levels with metal-on-metal hip surfaces. And studies show that loss of oxygen occurs at the femoral head during this operation. When the blood supply doesn't come back, osteonecrosis occurs. Without an adequate blood supply, the hip is also at increased risk for fracture.
More American surgeons may use this treatment option when results are better and follow-up studies show which patients can benefit from the operation.
Peter McLardy-Smith, FRCS, et al. Metal-on-Metal Hip Resurfacing: America, Where Are You? In Orthopedics. September 2006. Vol. 29. No. 9. Pp. 795-796.
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