The surgical gold standard for hip osteoarthritis is a total hip replacement. Millions of people perform this procedure to improve their function and quality of life. Besides arthritis, the total hip replacement also treats congenital hip dysplasia, avascular necrosis, rheumatoid arthritis and slipped capital femoral epiphysis.
However, the total hip replacement does not provide a durable solution for young people who are active. If you undergo total hip replacement, you can expect revision surgery in the future which is associated with a high morbidity.
Another alternative to total hip replacement is hip resurfacing. In this procedure, the bone conserves and allows for a greater range of motion and a lower rate of dislocation.
There are many alternatives to Hip Replacement Surgery and resurfacing could be an option for you.
The UK and Europe widely use hip resurfacing but in the US it has lost favor for several reasons. People with poor bone quality has a risk of bone fracture just underneath the metal cap that is placed on the top of the femur (thigh bone). Plus, there is a feeling that over time that harmful metal ions may escape into the bloodstream as a result of the two metal surfaces rubbing against each other.
In hip resurfacing, the surgeon does not completely replace the “ball” of the hip with a ceramic or metal ball. Instead, the surgeon reshapes the bone and caps it with a metal prosthesis. These two metal surfaces can potentially rub against each other and there are wear and tear, which can result in a release of metal ions.
While low levels of ions are of no importance, higher levels can cause toxicity. With a conventional hip replacement, the socket prosthesis lines with a thick layer of durable plastic, so that there is no metal on metal contact.
In general, hip replacement is advisable later in life so that the lifespan of the prosthesis matches the lifespan of the patient. Hip revision brings a poorer result that’s why it is so difficult to repeat the procedure. In the past, hip resurfacing is an option for young people with severe hip problems. It allows for more bone to be available for a hip replacement in future. Today, hip resurfacing usually recommends in patients with severe deformities and there are no other options.
The best candidates are young men with good quality bone. Finally, if you undergo hip resurfacing, seek for an experienced surgeon as the procedure is technically demanding. Hopefully, in the near future, ceramic resurfacing may be able to address the present problems of metal hypersensitivity and toxicity.