Hip Resurfacing


Hip resurfacing is a significantly different technique to a hip replacement.  Let's look at the differences.

Basically a hip replacement or hip resurfacing makes changes to both the femur (the thigh bone) and the acetabulum (part of the pelvis) together these two form the hip joint.

Femur Side 

With resurfacing the head of the femur is shaved and a metal cap is attached which covers the surface.

With a traditional replacement the head of the femur is cut off and a long, metal stem inserted into the bone. An artificial head is then attached to the stem.

Pelvis Side 

With resurfacing a metal cup is used with a replacement this might be made from metal, polyethylene or ceramic.

That's quite a difference isn't it?  With so much less bone being removed why then isn't this the favoured procedure?   Let's take a look at the advantages and disadvantages.

Hip Resurfacing
Advantages

  • Much less bone needs to be removed
  • Because the cap and the cup are of similar size to the originals there is thought to be significantly less risk of dislocation.
  • If revision work is needed there is substantially more bone stock to work with.
  • The patient will usually be able to live a full and active life. Even participating in marathons or Iron Man type events.
Replacement versus Resurfacing

Hip Resurfacing
Disadvantages

  • The technique is only suitable for younger patients and those with good bone stock
  • Due to post-menopausal related bone loss, older woman are not usually offered this form of surgery
  • The are serious concerns about the effects of chromium and cobalt ions released (due to friction in the new metal joint) these may give rise to metallosis and are known to pass through the placenta and thus may affect an umborn child. Depuy have recalled 93,000 metal on metal hip joints used in both hip replacement and hip resurfacing.

Although it is hard to get accurate, up-to-date figures some surgeons are now advising against this technique - others continue to recommend it

Other Facts

  • Approximately 5,000 resurfacing operations are performed annually in the UK.
  • The experience of the consultant is one of the most important factors in predicting outcome
  • The technique was first performed in Birmingham in 1977 and so is often referred to as Birmingham Hip Resurfacing or BHR.

Related Links: 

Metallosis 
Depuy Recall

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