Hip Resurfacing and Other Alternatives to Hip Replacement

More than 193,000 hip replacement surgeries are performed in the USA alone every year, according to data from the American Association of Orthopedic Surgeons, and although this surgery is safe and does not cause complications or require revisions 90 percent of the time, there is a possibility that the artificial surface will be subject to wear and tear over time. So if the patient is relatively young, they could need a revision in around 15 years’ time. There is also the risk of a dislocation if the artificial ball and socket are smaller than the normal natural ones and the hip is placed in certain positions. A viable and safer alternative to hip replacement surgery, especially if the patient is young, is hip resurfacing.

This surgical procedure is more advantageous because it involves less bone removal and therefore supports the preservation of bone. Also, the chances of a dislocation are minimized because the femoral head size is relatively larger. And even in case a revision is needed at a later date, it’s easier on both the patient and the surgeon because there is more bone to work with.

However, not everyone is a suitable candidate for hip resurfacing – the patient must be young enough and be clinically qualified by the surgeon, and he or she must not be obese, have non-inflammatory degenerative joint disease, have an infection, be allergic to the metals used in the implant, have severe bone loss in their femoral head, have femoral neck cysts, have rheumatoid arthritis, be very, tall, thin or small-boned, have poor blood supply to the femoral head, or have poor bone stock in the acetabulum. Hip resurfacing does have a few risks, the major of them being femoral neck fractures, aseptic loosening, and metal wear.

Besides hip resurfacing, there are other alternatives to total hip replacement the simplest of which is conservative management where the patient chooses not to undergo surgery and the pain is relieved and made manageable through other methods like physical therapy, cortisone injections and other anti-inflammatory medication, walking aids and joint supplements. The kind of care provided depends on the activity level of the patient.

Other options include:
. Short stem hip replacements with implants like the Proxima hip, Silent hip,

METHA hip sacrifice less bone on the femoral side and allow normal or near normal range of movements.

· Femoral Osteotomy: This procedure realigns the bones of the hip joint and is performed on the femur, the pelvis, or both. It is suited only for certain kinds of patients who suffer early arthritis of the hip joint because of conditions like hip dysplasia. The weight-bearing area of the patient’s hip should be able to be broadened for osteotomy to be a success. Recover is longer in this method than in a hip replacement.

· Arthrodesis: In this procedure, the head of the femur is fused to the acetabulam using a metal plate and screws. Although the fusion does not wear out like a hip replacement, the downside of this surgery is that mobility is lost at the hip and the patient may walk with a limp. Patients also have to use a cast during the recuperative period. A hip fusion or arthrodesis can be converted to a total hip replacement at a later date. This may be a suitable option for the very young patient in their teens as it will preserve their bone for a longer time.

· Resection Arthroplasty: This surgery removes the bone around the hip joint and allows the joint space to fill with scar tissue. It is usually done only on patients whose infection is extremely severe and whose arthritis is very advanced that they cannot even walk properly. Patients need to undergo therapy after surgery and be taught how to use an assistive device when walking.

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This article is contributed by Susan White, who regularly writes on the subject of Rad Tech Schools. She invites your questions, comments at her email address: susan.white33@gmail.com.