Hip resurfacing has evolved in the last eight years. The original
hip resurfacing replacements
were done 30 to 40 years ago and failed because of poor design and
the design has significantly improved. Hip resurfacing is still a
total hip replacement, however,
it is more bone conserving leaving the femoral neck and head attached.
If the hip fails then a
revision standard total hip replacement can be performed without much
Resurfacing a hip is similar to a total hip replacement from a
surgical perspective. Instead
of resecting the arthritic femoral head, the head is reshaped and
resurfaced with a metal
mushroom-like cap. This is cemented in place. The socket is prepared
in a similar fashion
to a total hip replacement. The socket is press-fitted into the
acetabular bone and bone
grows into the socket.
Risks of hip resurfacing replacement are similar to total hip
replacement. In addition to
those standard risks a hip resurfacing replacement may fail due to a
femoral neck fracture
or softening of the bone (avascular necrosis).
The advantages of hip resurfacing replacement include reduced
dislocation, restores leg
lengths, restores “normal anatomy” and the hip appears to be more
one to perform higher impact activity. The metal on metal technology
has been present
for the past 30 years and has proved successful.
Minimally invasive hip resurfacing replacement surgery
Instruments have been designed that allow for smaller incision
surgery. This is reflected
in less tissue damage and slightly quicker recovery rates. The wounds
are also a little
smaller. It must be pointed out, however, that six months following
the surgery there
is no difference in the outcome between a standard incision hip and a
mini incision hip.
Navigation is the latest technology that allows more accurate
placement of the
components to re-establish the normal hip biomechanics. This new