Question:I recently had an operation to save my hip joint. Instead of doing a total hip replacement, the surgeon resurfaced both sides of the joint. I remember them telling me that if it didn't work, I could always have the joint replaced later. I don't remember what could go wrong to make that necessary.
Answer:Hip joint resurfacing has gained in popularity over the last 10 years. With better implant materials and improved surgical techniques, the results have improved favorably.
In this operation, instead of removing the head and neck of the femur (thigh bone) and replacing them with a chromium, titanium, or ceramic implant, the surface is smoothed and capped. The same thing is done to the inner lining of the acetabulum (socket).
The procedure is much more difficult to do compared with a total hip replacement. But the surgeon is able to save more of the bone. This is important, especially in younger patients with osteoarthritis. They can always have a revision surgery later to replace the resurfacing liners with a total joint replacement.
The most common problem that develops after resurfacing is a fracture of the femoral neck. Loosening of the implant parts can occur. Infection or hip subluxation (partial dislocation) are also reported complications.
Most of these problems occur early on after the operation (within the first few months). Sometimes the resurfacing can be saved and no further operations are needed. But in other cases, a second (revision) surgery is needed. The hip may need to be completely replaced.
The incidence of serious complications of this type is fairly low. Skilled surgical technique and careful patient selection has led to reduced rates of fractures and higher rates of success.David R. Marker, BS, et al. Femoral Neck Fractures After Metal-on-Metal Total Hip Resurfacing. A Prospective Cohort Study. In The Journal of Arthroplasty. October 2007. Vol. 22. No. 7. Supplement 3. Pp. 66-71.
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