Hip Resurfacing

What is Hip Resurfacing?

Hip Resurfacing procedure has been promoted as an alternative to Total Hip Replacement and is commonly indicated in patients younger than 55 years of age. It involves the removal and replacement of the surface of the femoral head with a hollow metal hemisphere. This hemisphere fits into a metal acetabular cup. This technique conserves femoral bone and does not compromise the possibility of future Total Hip Replacement if need be. Hip Resurfacing can be Partial Hip Resurfacing or Total Hip Resurfacing. In Partial Hip Resurfacing the femoral shell is implanted over the femoral head. In Total Hip Resurfacing, acetabular and femoral shell are implanted. Partial Hip Resurfacing is considered a treatment option for avascular necrosis with collapse of the femoral head and preservation of the acetabulum. Total Hip Resurfacing is performed in patients who suffer from osteoarthritis, rheumatoid arthritis, and advanced avascular necrosis. Total Hip Resurfacing may be considered an alternative to Total Hip Replacement.

Where can I get Hip Resurfacing?

Country	Cost with MedSolution
India	$8,500 (inquire)

Cost of procedure performed in the US: $25,000.

All prices are in US dollars and include the cost of the procedure and minimum hospital stay. Estimates and minimum hospital stay will vary depending upon individual needs and requirements.

What are the indications for Hip Resurfacing?

The indications for Hip Resurfacing surgery include avascular necrosis of hip bone, primary or secondary osteo-arthritis, arthritis following hip fractures, ankylosing spondylitis, long standing perthes disease or a dysplastic hip.

What is the procedure for Hip Resurfacing?

The actual procedure of Hip Resurfacing surgery is much less invasive than conventional Hip Replacement. The area of arthritis in the hip joint is cleaned and shaved out. The surgery for Hip Resurfacing consists of the femoral head being shaved and re-shaped to accept the metal cap with small guide stem. The size of the femoral head is about 50 mm in diameter. The metal cup is set into the pelvis. The parts mostly used for Hip Resurfacing are made from Cobalt-chrome cast. These parts are shaped precisely by a machine to fit each other with small space for body fluid to lubricate. The backside of the cup has a roughened surface to allow bone to grow into implant. One end of the cup is fixed over the ball of the femur bone, and the other end is fixed into a socket in the pelvic bone called acetabulum. This preserves the body's vital bone. It takes about one and a half hours to perform the Hip Resurfacing procedure. The hospital stay is only about 5 - 7 days. You will be able to get out of bed and walk within 2 days of the Hip Resurfacing surgery.

Who are the ideal candidates for Hip Resurfacing?

The ideal candidates for Hip Resurfacing surgery are younger adults who perform a high level of physical activity. There is no activity restriction after Hip Resurfacing surgery as there is hardly any risk of dislocation (you can sit on floor, squat, use Indian toilet, etc). Sport and high demand activities are encouraged after the Hip Resurfacing surgery as joint usage is not related to life of Hip Resurfacing implant.

Who should not undergo Hip Resurfacing?

Patients with very severe osteoporosis, who have been bed-bound for long periods of time, patients with renal failure, people who are above 70 years of age should not undergo Hip Resurfacing surgery

What is the outcome of Hip Resurfacing?

Hip Resurfacing surgery has a 99% success rate. Many adolescent patients have had the Hip Resurfacing procedure with excellent results. Procedure can be done soon after skeletal maturity. Following Hip Resurfacing, there is faster rehabilitation and early discharge from hospital.

B . R . A . N . D . of Hip Resurfacing

Benefits of Hip Resurfacing

• The Hip Resurfacing is a more conservative and less traumatic approach than Total Hip Replacement. The Hip Resurfacing procedure is preferred by younger patients who enjoy an active life. There are several benefits of Hip Resurfacing surgery i.e. restoration of normal anatomy and function of the hip joint allowing you to perform higher impact activity, minimal bone loss, elimination of the risk of micro-fracture. Large size of ball reduces the risk of dislocation, stress is transferred in the natural way through the head and the neck of the femur, future loosening bone loss due to osteolysis is prevented by the use of metal rather than plastic. Metal implant has a longer life due to low rate of wear and tear.

Risks of Hip Resurfacing

• The Hip Resurfacing techniques are rather new and there is lack of long-term track record of this procedure. Current devices that are available have only been used for the past few years in the Hip Resurfacing procedure. Despite the fact that there is low rate of wear and tear of the hip joint following Hip Resurfacing, longevity and longterm effects of presence of debris due to wearing of the hip joint are unknown. For some surgeons, the Hip Resurfacing procedure has a longer surgical time. Hip Resurfacing requires skilled surgeons and excellent post-operative care.

Alternatives to Hip Resurfacing

Other surgical alternatives to Hip Resurfacing are used to relieve the symptoms of arthritis of hip joint. These include:

• Arthrodesis - In this procedure the femur is fused to the pelvis. This procedure is mainly used as an alternative to Hip Resurfacing in children in children who have unilateral degenerative disease of the hip and are unresponsive to non-operative measures.
• Arthroscopy - This is a minimally invasive surgical procedure which is used to investigate and treat traumatic and non-traumatic disorders of the hip joint. This procedure is performed by means of an arthroscope which is a thin telescope like instrument that is introduced into the joint in order to visualize the anatomical structures
• Osteotomy - The aim of osteotomy in dysplastic or osteonecrotic hips is to restore and realign the position of the joint by means of a fixation device. If you are affected by osteonecrosis, the major goal of surgery is to move the necrotic segment away from the weight bearing area and restore blood supply to the necrotic zone.

Now or Never

• The results of timely Hip Resurfacing may be everlasting with excellent restoration of full function and range of movement of the hip joint. This method is widely used to treat degenerative diseases of the hip joint. There is faster rehabilitation and discharge from the hospital so that you can indulge and enjoy full sporting activities including competitive sports like judo and squash after Hip Resurfacing surgery. There is hardly any risk of hip joint dislocation following Hip Resurfacing.

Decision to have Hip Resurfacing

• It all boils down to this! Hip Resurfacing offers excellent results i.e. less chance of dislocation, less thigh pain compared to Total Hip Replacement, with the chance that they could last as long or maybe longer than the artificial joint implants. Should this procedure not last too long, at least there is enough preserved femur bone to have Total Hip Replacement if needed in the future. If you go for Total Hip Replacement as a first choice, then there is no going back to Hip Resurfacing if this procedure becames a widely accepted treatment for problems of hip joint.