Hip Resurfacing

Hip resurfacing is a procedure that is used to relieve pain and restore function for people with arthritis or other hip conditions.  Unlike traditional total hip replacement, hip resurfacing does not remove the bones in the joint, but instead resurfaces the bone with smooth metal.  Hip resurfacing conserves bone and is a less-invasive procedure than total hip replacement.  Younger active people are the best candidates for hip resurfacing.  Overall, hip resurfacing is a successful procedure and allows the majority of people to return to the activities that they enjoyed before experiencing hip pain.

Your hip is a ball and socket joint.  The top of the thighbone (femur) is shaped like a ball (femoral head).  The ball fits into a cup-shaped socket (acetabulum) in the pelvis bone.  The socket holds the ball in place and allows it to rotate during motion.  The surfaces of the bones are covered with smooth cartilage that cushions the ends of the bones and allows them to move easily.

Arthritis is a major cause of joint pain and stiffness in the hip.  Arthritis can develop for many reasons, including aging, “wear and tear,” injury, disease, and hip structure abnormalities.  Arthritis can cause the protective cartilage to wear away and lead to painful bone-on-bone rubbing.

The main symptom of severe hip arthritis is pain.  You may feel pain in your hip, groin, thigh, buttock, and sometimes in the knee.  The pain may occur with activity or at rest.  It may even keep you awake at night.

Your hip may feel stiff.  You may have difficulty moving or lifting your leg.  You hip pain may eventually limit your every day activities, such as walking, stair climbing, and bending. 

Your doctor can diagnose arthritis by reviewing your medical history and conducting a physical examination.  You will be asked about your symptoms and level of pain.  Assessments of  muscle strength, joint motion, and hip alignment will be made.  Blood tests and other laboratory tests may be used to identify the type of arthritis that you have.

 

Your doctor will order X-rays to see the condition of your bones and identify areas of arthritis or abnormal bone growths, such as bone cysts or bone spurs.  Sometimes the tissues that surround the hip joint or the condition of the bones do not show up on an X-ray.  In this case, your doctor may order magnetic resonance imaging (MRI) scans or a bone scan, which show more detail.  X-rays, MRI scans, and bone scans are painless tests that simply require that you remain motionless while the images are taken.

As your arthritis progresses, medications, rest, and physical therapy may no longer provide you with symptom relief.  You should discuss hip resurfacing with your doctor to find out if you are a good candidate for the procedure.  Ideal patients for hip resurfacing are active and younger.  Females under the age of 55 and males under the age of 65 are considered within typical guidelines.  Inactive people, significantly older adults, or those with some specific types of arthritis are not good candidates for hip resurfacing. 

Hip resurfacing is an inpatient surgery.  You will be anesthetized for the procedure.  Your surgeon will make an incision to access the hip joint.

Your surgeon will remove damaged cartilage from the head of the femur and prepare it for the resurfacing component.  The hip socket is prepared in the same manner.  The replacement socket is placed and the resurfacing head component is attached to the femur.  The incision is closed and a drainage tube is usually placed to help remove fluids.

You will probably spend a short period of time in the hospital following your procedure.  Walking with crutches begins the day after surgery.  You may be referred to physical therapy to learn low impact exercises to strengthen your hip.  Your doctor will increase your activity level and the sports you may participate in as you heal.  Recovery is individualized, and your doctor will let you know what to expect.

The first 6 to 12 months after hip resurfacing are the most vulnerable time in the healing process.  This is when your bone grows and heals.  You should avoid heavy lifting, squatting, jogging, twisting, and high impact sports to prevent injury.  Your doctor will let you know when you can resume driving and sexual relations.  You should contact your surgeon if you develop pain or swelling.