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Question
Hip resurfacing: An alternative to conventional hip replacement?
What can you tell me about hip resurfacing as an alternative to hip replacement? What are the pros and cons?
Answer
from Mark Spangehl, M.D.
Unlike traditional hip replacement, hip resurfacing doesn't replace the "ball" of the hip with a metal or ceramic ball. Instead, the damaged hip ball is reshaped and capped with a metal prosthesis. The damaged hip socket is fitted with a metal prosthesis — similar to what is used in a conventional hip replacement.
With newer materials, the artificial joint implants used for total hip replacement last about 15 years. This isn't an issue for older people who receive a hip replacement late in life. But hip resurfacing might be a better choice for younger people because the procedure leaves more bone intact, which can make it easier to perform a total hip replacement if needed later.
Resurfacing generally results in a bigger hip ball than what is typically used in a conventional hip replacement, which may reduce the risk of dislocation. But newer implants used for conventional hip replacement now offer the option of a larger hip ball, similar in size to what results from hip resurfacing procedures.
Hip resurfacing is technically more difficult and generally requires a larger incision than what is used for a conventional hip replacement. And the risk of complications is slightly higher with hip resurfacing — even when controlling for factors such as your age, sex and activity levels.
Hip resurfacing isn't recommended for people who have:
- Osteoporosis
- Impaired kidney function
- Known metal hypersensitivities
- Diabetes
- Large areas of dead bone (avascular necrosis)
- Surgical approaches and techniques: Resurfacing arthroplasty. In: Canale ST, et al. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa.: Mosby Elsevier; 2007. http://www.mdconsult.com/das/book/body/117550049-3/795083458/1584/51.html#4-u1.0-B978-0-323-03329-9..50010-6--cesec31_360. Accessed Jan. 22, 2009.
- Skerker RS, et al. Total hip replacement. In: Frontera WR, et al. Essentials of Physical Medicine and Rehabilitation. 2nd ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/117550049-3/795083458/1678/56.html#4-u1.0-B978-1-4160-4007-1..50055-9--cesec13_877. Accessed Jan. 22, 2009.
- Sprangehl M (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 30, 2009.
