Patients with advanced arthritis of the hip may be candidates for either traditional total hip replacement (arthroplasty) or hip resurfacing (hip resurfacing arthroplasty). Each of these procedures is a type of hip replacement, but there are important differences. Your orthopaedic surgeon will talk with you about the different procedures and which operation would be best for you.
In a traditional total hip replacement, the head of the thighbone (femoral head) and the damaged socket (acetabulum) are both removed and replaced with metal, plastic, or ceramic components.
In hip resurfacing, the femoral head is not removed, but is instead trimmed and capped with a smooth metal covering. The damaged bone and cartilage within the socket is removed and replaced with a metal shell, just as in a traditional total hip replacement.
Hip resurfacings may be easier to revise. Because the components (called implants) used in hip replacements and hip resurfacings are mechanical parts, they can — and do — wear out or loosen over time. This typically occurs between 10 and 20 years after the procedure, although implants may last longer or shorter periods of time.
If an implant fails, an additional operation may be necessary. This second procedure is called a revision and it can be more complicated than the initial operation. Because hip resurfacing removes less bone from the femur (thighbone) than a traditional hip replacement, many surgeons believe it is easier to exchange implants that fail after hip resurfacing.
Decreased risk of hip dislocation. In hip resurfacing, the size of the ball is larger than in a traditional hip replacement, and it is closer to the size of the natural ball of your hip. Because of this, it may be harder to dislocate. This stance is controversial because several factors can affect the risk of dislocation, such as surgical approach, and the type and size of the implants used.
More normal walking pattern. Several studies have shown that walking patterns are more natural following hip resurfacing compared to traditional hip replacement. These differences in walking are quite subtle, however, and special instruments are needed to measure them.
Greater hip range of motion. Hip resurfacing patients are usually able to move their hips in a greater range of motion than total hip patients. However, certain total hip implants can achieve the same range of motion as hip resurfacings.
You will likely be admitted to the hospital on the day of surgery.
Before your procedure, your Wisconsin Bone & Joint orthopedic physician will evaluate you. He or she will review your medical history and discuss your surgical procedure with the hospital Anesthesiologist. The Anesthesiologist will then discuss your anesthesia choices with you. You should also have discussed anesthesia choices with your WBJ surgeon during your preoperative clinic visits. Anesthesia can be either general (you are put to sleep) or spinal (you are awake but your body is numb from the waist down).
Before your procedure begins, and in the operating room, your WBJ surgeon will also see you before surgery and sign your hip to verify the surgical site.
A hip resurfacing operation typically lasts between 1 1/2 and 3 hours.
Your WBJ surgeon will make an incision in your thigh in order to reach the hip joint. The femoral head is then dislocated out of the socket. Next, the head is trimmed with specially designed power instruments. A metal cap is cemented over the prepared femoral head. The cartilage that lines the socket is removed with a power tool called a reamer. A metal cup is then pushed into the socket and held in place by friction between the bone and the metal. Once the cup is in place, the femoral head is relocated back into the socket and the incision is closed.
After the surgery you will be taken to the recovery room, where you will be closely monitored by nurses as you recover from the anesthesia. You will then be taken to your hospital room.