Houston Methodist. Leading Medicine

Hip FAQ

Question:

I am only 45 years old buy my right hip has deteriorated to the point that I have a hard time walking. The doctor said it was caused by osteoarthritis. He will do a replacement surgery on me but he says that he's only doing part of a replacement, called resurfacing. Wouldn't it make more sense just to take the whole thing out and replace it once and for all?

Answer:

When hip replacements, or arthroplasties, first became common, they were done mostly on patients in their late 60s or older. At that point, as the patients aged, their replacements' life span seemed more than adequate. However, as people are developing problems with their joints earlier, such as you have, or are living longer, surgeons are beginning to rethink how they approach replacements and what to do if - and when - patients outlive their replacements. What the surgeons and researchers learned was that revision surgeries were needed when replacements failed, but if they had taken out the entire joint and replaced it, it could be that there wasn't enough bone left to do such a revision. By doing partial replacements, the surgeons leave behind more bone that they can work with if they need to operate again later. The type of replacement that you mention, resurfacing, takes away even less bone than a traditional partial replacement. With this surgery, only the damaged surface of the joint and/or ball of the bone is resurfaced and replaced, leaving everything else intact. Jozef Zustin, MD, et al. Morphologic Analysis of Periprosthetic Fractures After Hip Resurfacing Arthroplasty. In The Journal of Bone & Joint Surgery. February 2010.  Vol. 92-A. No. 2. Pp. 404-410.

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