Question:In the early 1980s I had hip surgery to resurface the joint rather than replace it. Everything was fine for the first 10 years. After that it was one thing and then another. I finally had to have a total hip replacement. Did this happen often or am I a rare bird?
Answer:Hip joint resurfacing was very popular in the late 1970s and early 1980s as a way to preserve bone in younger patients. Instead of replacing the joint completely, the top of the femur (thighbone) is smoothed and capped. The same may be done to the hip socket.
Years ago the materials used for hip joint resurfacing (plastics) wore down and failed. Today, metal-on-metal is used instead. And cement used back then also caused problems with loosening. Newer techniques use a cementless fixation technique.
Over time studies showed a high failure rate for joint resurfacing. As many as two thirds of the patients had to have the joint resurfacing replaced with a total hip. And long-term studies into the third decade now continue to show a poor survival rate for the hip resurfacing procedure.
So you weren't a rare bird at all but merely an early bird. Surgeons are advised to use this procedure with caution. It's still a good choice for some patients --especially younger patients. It helps preserve bone and makes revision easier when and if you do need a total hip replacement.Merrill A. Ritter, MD, et al. Failure Mechanisms of Total Hip Resurfacing. In Clinical Orthopaedics and Related Research. December 2006. No. 453. Pp. 110-114.
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