I had a hip resurfacing procedure done for hip dysplasia on the right hip. I heard a medical report on NPR (national public radio) that seemed to indicate the risk of failure for this treatment is higher than for people who had the same operation for arthritis. What do you know about this?
The American Academy of Orthopaedic Surgeons (AAOS or Academy) asked a panel of nine surgeons from around the United States to review the status of metal-on-metal hip resurfacing and publish a summary. Here are a few points that made that might be relevant to your question and situation.
Resurfacing can indeed be used both for patients with osteoarthritic changes of the hip as well as for those who have dysplasia of the hip from birth. Dysplasia means the hip socket is too shallow to hold the femoral head in place. Partial or complete hip dislocation is often the result.
After reviewing all of the available studies, they found that hip resurfacing may be more successful for hip osteoarthritis than for hip dysplasia. But further study is needed before making any recommendations in this area because there are other factors to consider besides diagnosis.
For example, the age and sex of the patient, type of implant used, and whether the implants are cemented or not can possibly affect the measured outcomes. Risk factors for resurfacing failure include small component size (used more often in women than men) and age (risk increases with age; older than 75 has the highest risk of failure). Younger age (less than 55) is more of a risk factor for total hip replacements.
Other factors have been studied such as smoking, body mass index (BMI), activity level, and menopausal status. None of these seemed to be significant in terms of success or failure of the resurfacing procedure. But the studies done so far are fairly limited in scope. The panel could not make any firm statements regarding the effect of these particular patient characteristics on outcomes or revision rates for hip joint resurfacing.
Brian McGrory, MD, et al. Modern Metal-on_Metal Hip Resurfacing. In Journal of the American Academy of Orthopaedic Surgeons. May 2010. Vol. 18. No. 5. Pp. 306-314.
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