I'm looking into the possibility of having a hip joint resurfacing procedure done instead of a total hip replacement. I've heard all about the positives of this operation from my surgeon. Could you fill me in on any down sides there might be?
Hip resurfacing arthroplasty is a type of hip replacement that replaces the arthritic surface of the joint but removes far less bone than the traditional total hip replacement. Because the hip resurfacing removes less bone, it may be preferable for younger patients that are expected to need a second, or revision, hip replacement surgery as they grow older and wear out the original artificial hip replacement.
You are asking, how well do they work? And what are the potential problems or complications? Using data from the 1000s of hips done outside of the United States along with studies done in the states, it's clear that the overall revision rate is still higher for resurfacing than for standard total hip replacements. But the rate is still small enough to make it worth having the procedure for the many patients who aren't ready yet for a complete total hip replacement.
The most common complications are femoral neck fracture, implant dislocation, and metal ion hypersensitivity. Because the component parts of the implant are metal, tiny pieces of metal ions flake off and get trapped inside the joint forming a tumor-like cyst or entering the blood stream. This could become a problem for anyone with metal hypersensitivity.
Studies show that women are more likely to have a failed resurfacing procedure. So are patients who've had a previous hip surgery or anyone who has osteonecrosis (loss of blood supply to the top of the femur or thighbone causing death of bone cells). And anyone with inflammatory arthritis or developmental dysplasia of the hip is at increased risk for implant failure.
Joint resurfacing is a wonderful stop-gap measure for patients with painful arthritic conditions. By preserving as much bone as possible, it buys them some time before converting to a total hip replacement. The beauty of this plan is that it allows younger patients to remain active and put off the inevitable hip replacement. This intermediate step is important since hip implants don't last forever.
James Phelps, et al. Hip Reconstruction. Current Status of Hip Resurfacing Arthroplasty. In Current Orthopaedic Practice. January/February 2009. Vol. 20. No. 1. Pp. 2-7.
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