Hip resurfacing arthroplasty is surgery that replaces the
damaged outer surfaces of the femoral head found at the top of the thighbone
and, if needed, the cup-shaped socket where the thighbone meets the pelvis
in the hip joint.
People younger than about age 55 who have hip
osteoarthritis have been difficult to help with standard hip replacements. They
have many years of activity ahead of them and put a lot of stress on their
replaced hip joint. So their hip replacements often need to be redone a few
years after the original surgery. These later surgeries are usually less
successful than the original hip replacements.
removes less bone than a hip replacement and maintains a better ball and socket
joint. The chances of hip dislocation are less than with hip replacement. And
people usually find the hip eventually feels normal after the surgery. Also, if
the hip resurfacing parts eventually need to be replaced, there is enough bone
remaining to do a standard hip replacement.
Hip resurfacing seems to work best for people who have a larger "ball" (femoral head) at the top of their thigh bone. Women, and men with smaller femoral heads, may be more likely to need further surgery than if they had a total hip replacement.1 And it is not clear that people with severe osteoarthritis who have hip resurfacing are able to be more active than people who have hip replacement.2 Long-term studies of hip resurfacing have not been done. If you are considering hip surgery for severe osteoarthritis, talk to your doctor about the risks and benefits of each type of surgery.
Smith AJ, et al. (2012). Failure rates of metal-on-metal hip resurfacings: Analysis of data from the National Joint Registry for England and Wales. Lancet, 380(9855): 1759–1766.
Costa ML, et al. (2012). Total hip arthroplasty versus resurfacing arthroplasty in the treatment of patients with arthritis of the hip joint: Single centre, parallel group, assessor blinded, randomised controlled trial. BMJ. Published online April 19, 2012 (doi:10.1136/bmj.e2147).
April 8, 2013
Anne C. Poinier, MD - Internal Medicine
& Kenneth J. Koval, MD - Orthopedic Surgery, Orthopedic Trauma
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