Hip resurfacing, also known as hip resurfacing arthroplasty, is a form of hip replacement surgery. In this procedure the damaged bone and cartilage of the hip joint socket is removed and replaced in much the same way as in a total hip replacement. The significant way that hip resurfacing differs from a total hip replacement is that the head of the femur is preserved and capped rather than removed. A hip resurfacing procedure may be considered when chronic hip pain and disability have not responded to conservative treatment and interfere with normal daily activities.
The hip joint is one of the most flexible joints in the body. It is located at the meeting point of the rounded head of the femur and the cavity-shaped acetabulum of the pelvic bone. The hip joint is a ball and socket joint with the rounded head of the femur being the ball and the curved depression that is known as the acetabulum being the socket. As one of the largest weight bearing joints in the body, the hip joint is made to withstand the tremendous forces that activities such as walking, running and jumping generate.
There are a number of conditions that can damage the hip joint and lead to the need for a hip resurfacing procedure. The most common of these conditions is osteoarthritis, which is a form of arthritis that is associated wear and tear on the joints and is typically seen in individuals over the age of 50. In cases of osteoarthritis of the hip, the articular cartilage covering the surfaces of the ball and socket wears out leading to painful bone on bone contact. Symptoms of hip pain, inflammation, stiffness, and impaired mobility arise. As the damage progresses the symptoms increase in severity. Hip resurfacing is one of the procedures considered to alleviate the symptoms and restore the consequences of osteoarthritis as well as treatment for similar damage caused by other conditions including rheumatoid arthritis, traumatic arthritis, avascular necrosis, and developmental hip dysplasia.
One of the benefits of a hip resurfacing procedure as compared to a standard total hip replacement is the preservation of bone. Although the socket is treated and replaced with a metal shell in a similar manner to a traditional total hip replacement, the “ball,” which is head of the femur, remains relatively intact. Only a little bone is trimmed from the head of the femur before it is capped with a smooth metal covering. It is also thought that this procedure may reduce risk of post- surgical dislocation since the size of the head of the femur with the cap more closely resembles the size of the natural femoral head. Additionally, the procedure is easier than a total hip replacement to revise if a second surgery is ever needed to replace loose or worn out parts. Among the drawbacks of a hip resurfacing procedure is the risk of fracturing the neck of the femur (requiring a total hip replacement).
Hip resurfacing is not suitable for all cases. In general resurfacing procedures are more often a consideration in a young patient who has osteoarthritis and wants to continue an active lifestyle.