Hip resurfacing surgery, also known as hip resurfacing arthroplasty, is an orthopaedic procedure that replaces the lining of the ball and socket of the hip with metal implants. This technique preserves much more of the natural bone than total hip replacement making it a good option for younger patients who want to avoid total hip replacement for as long as possible.
Why Have Hip Resurfacing Surgery?
Hip resurfacing may be a good option for any patient who suffers from hip pain caused by localised arthritis, inflammation, prior injury, or natural wear and tear who wants to avoid a total hip replacement.
Unlike total hip replacement where the entire top of the thigh bone called the femur is removed to place the implant, hip joint resurfacing only removes enough bone to place metal implants. These implants cover the surfaces of the ball and socket of the joint. Replacing the surfaces of the joint with metal implants allows for smoother movement with less pain.
Hip resurfacing patients are less likely to suffer from hip dislocation than hip replacement patients. The general preservation of bone also means it is a much easier procedure to revise if necessary in the future if an implant loosens or wears out. The best candidates are generally under 60 years old and live an active life.
Any patient with severe hip damage caused by osteoarthritis or another bone disease will not be a good candidate for hip joint resurfacing as the implants can only be attached to healthy bone. Women may not be recommended for hip resurfacing because of bone density issues related to osteoporosis.
Also, any patient of childbearing age who plans to become pregnant may not be recommended for hip joint resurfacing because of the small chance they have an immune reaction to metal ions caused by the implants. While a rare complication, most surgeons will avoid this risk and suggest another procedure like a total hip replacement to these patients instead.
How Much Does Hip Resurfacing Surgery Cost?
In the UK, private hip resurfacing surgery costs from £9,500 to £13,500 or more. This broad price range depends on a number of factors. The location of the hospital and the pre- and postoperative services included in the cost are the most likely aspects to change the price.
The Hip Resurfacing Procedure
The average hip joint resurfacing surgery takes between 1 and a half to 3 hours to complete. Depending on the patient, this surgery can be performed under general anaesthesia when the patient is given medication that puts them in deep sleep or with a spinal block also called an epidural.
Spinal blocks are injected directly into the spinal cord and numb the body below that injection point. During surgery, the patient with a spinal block is also given sedatives to keep them relaxed during the procedure.
Incisions for Hip Resurfacing Surgery
The location of the incision for hip joint resurfacing surgery depends on the surgeon’s technique. Depending on the surgeon’s preference and a patient’s unique anatomy, the incision is placed vertically on the front, side, or back of the hip.
Hip Resurfacing Procedure
Once the incision is made, the surgeon begins by removing cartilage and some bone from the socket and ball of the hip. They then attach one implant to the ball of the joint on the femur with medical cement. The other implant is placed in the socket of the joint in the hip. This implant is held in place by friction, so no cement is necessary. Once the surgeon is happy with the fit of the implants, they close the incision and the surgery is complete. Patients spend anywhere from 1 to 4 nights in hospital after hip resurfacing surgery depending on their overall recovery and health after surgery.
Physiotherapy and Recovery After Surgery
A mobility aid such as crutches or a walker may be necessary for a few days or weeks after hip resurfacing surgery. Physiotherapy may be recommended after hip joint resurfacing to ensure the muscles and tendons around the hip heal well and are strong enough to support the improved mobility provided by the resurfaced hip joint. These physiotherapy sessions will likely take place weekly and continue for a few weeks or months depending on the patient’s recovery.
Most hip resurfacing patients are able to continue most of their daily activities as usual 6 weeks after surgery. It is also important to know the lifespan of hip joint resurfacing implants ranges from 10 to 20 years. After this time you may be recommended revision surgery to replace the implants or total hip replacement.
Potential Hip Resurfacing Risks & Complications
Any surgery is associated with risks and complications due to the nature of surgery and anaesthesia.
General risks and complications associated with surgery include:
- Blood clots
- Excessive bleeding
There are also risks and complications associated with hip resurfacing specifically. These are usually related to the bone density of the patient or the implants. Risks and complications of hip joint resurfacing surgery include:
- Damage to blood vessels near the hip
- Nerve damage resulting in altered sensation
- Fracture at the head or neck of the femur
- Hip dislocation
- Implant loosening or failure
- Mobility problems caused by misalignment of implants
- Bone weakening or softening surrounding the implants
- Hypersensitivity or immune responses caused by metal ions created by the implants