For the young, active patient with advanced hip disease, hip resurfacing can be an alternate treatment to total hip replacement. The procedure is regaining popularity and holds great promise since it often permits a return to normal life activities.

Total hip resurfacing versus total hip replacement

For those suffering from severe hip arthritis, total hip replacement is a very successful treatment option. With this procedure, the worn out head of the femur is removed, then the inside of the femur is reshaped and replaced with a stem and metal ball that fits into the center of the femur. In addition, the socket of the pelvis is reshaped and fitted with a two-part implant that consists typically of a metal shell and plastic liner. Over time, friction associated with the metal ball rubbing against the plastic liner can cause particles of the plastic to wear away. These particles can get caught between the bone and cause loosening and failure of the stem and cup.

For younger, active patients who need a total hip replacement, there is a chance that traditional hip replacements will wear out during their lifetime and may need to be replaced again. Revision hip replacement is much more difficult and may not last as long as the original hip replacement.

The metal on metal technology used in hip resurfacing often eliminates the problems associated with metal on plastic wear, offering an option that may last for many years.

Total hip resurfacing

For some younger, active patients, the best course of action is often total hip resurfacing. Since the head of the femur is preserved, hip resurfacing conserves more of the bone. This is largely due to the fact that instead of removing the head completely, it is shaped to accept an anatomically sized metal sphere. And there is no large stem to go down the central part of the femur. Also, the surface of the socket, acetabulum, is resurfaced and replaced with a metal shell that is pressed directly into the bone.

The implant

The hip resurfacing implant, such as the BIRMINGHAM HIP* Resurfacing System implant, is made of two parts working together to restore the original function of the ball-and-socket joint. These two parts consist of a metal mushroom-like cap, which is inserted over the top of the resurfaced femoral head, and a metal cup that is pressed into the socket. The bone then grows into the socket adding increased stability.

The metal on metal hip resurfacing implant offers a significant advantage over traditional total hip replacement implants. Its larger diameter enables your surgeon to reconstruct the hip to more closely match the natural hip, avoiding dislocation after surgery. During the first five years after traditional total hip replacement, about 1-4% of patients will suffer dislocation. However this larger metal on metal joint replacement reduces the odds to 0.3%, offering improved stability and less restrictions.

Who is a candidate for hip resurfacing?

Hip resurfacing is intended for young, active adults who are under 60 years of age and in need of a hip replacement. There are certain causes of hip arthritis that result in extreme deformity of either the head of the femur or the acetabulum. These cases are usually not candidates for hip resurfacing.

Regular consideration of hip resurfacing is given to those under the age of 60, while those over 60 who are living non-sedentary lifestyles may also be considered for this procedure. However, this can only be further determined by a review of your bone quality.

Talk with your orthopaedic surgeon to find out more about the BIRMINGHAM HIP Resurfacing System implant and if hip resurfacing is the right option for you.

*Trademark of Smith & Nephew.