Houston Methodist. Leading Medicine

Hip FAQ

Question:

Two years ago, I had my right hip joint resurfaced in an effort to reduce pain, stay active, and hold off on a total joint replacement. Everything's going fine but I find myself worrying that something will go wrong. At this stage in the game, am I still at risk for a hip dislocation or fracture? Those are the things I was warned about at the beginning. Can I get out there on the golf course and swing freely? What about playing tennis? I confess I just haven't tried doing much for fear of breaking my hip.

Answer:

Hip Resurfacing is a new way to manage painful joint destruction at an age too young for a total hip replacement. Active adults thinking about having this procedure done (or like you have already had it done) want to know -- how active can I be after recovery? Can I run? Play tennis? Join a soccer team? Go skiing? 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. Special powered instruments are used to shape the bone of the femoral head so that the new metal surface will fit snugly on top of the bone. The cap is placed over the smoothed head like a tooth capped by the dentist. The cap is held in place with a small peg that fits down into the bone. The patient must have enough healthy bone to support the cap. The hip socket may remain unchanged but more often it is replaced with a thin metal cup (the acetabular component). In theory, the level of physical and sports activity might cause the component parts to loosen or wear out. There is an additional fear of fracture or hip dislocation. But in reality, we really don't know if these problems are likely or not. Surgeons may caution patients to reduce their participation in high-level impact sports in favor of low-impact sports. Instead of playing tennis, soccer, or volleyball, they might be advised to stick with fitness and weight training or riding a bicycle. Some of the more active, athletic patients may think this is pretty boring and unacceptable. They may be looking for solid evidence to prove these restrictions are necessary. There's really no evidence to support one approach over another (i.e., inactivity versus activity). All the research on physical activity and exercise in general supports staying active as a way of maintaining good health. Currently, there are no universal or standard guidelines for activity after hip resurfacing. Short-term reports focused on activity level show that patients are all over the map from reducing their activity level to resuming previous activity levels (including full sports participation). Precautions are given at first to prevent complications like hip fracture or dislocation. There is always a risk of these things happening in older adults, especially anyone who is osteoporotic (has low bone mass density). Weight-bearing activities and exercise are actually ways to prevent osteoporosis. You should be safe to engage in low-to-intermediate impact activities such as walking, bike riding, weight-training, or fitness exercise. High impact activities such as tennis, running, skiing, and other active sports may be okay, too. Check with your orthopedic surgeon first and make sure there are no specific reasons why you should avoid such activities. Marc Manerjee, MD, et al. Sports Activity After Total Hip Resurfacing. In The American Journal of Sports Medicine. June 2010. Vol. 38. No. 6. Pp. 1229-1236.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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