Hip resurfacing, which is more similar to a tooth cap than a hip implant, is a new option for young, active people who have good bones, but need new hips.

Rather than replacing the entire hip joint, as in a total hip replacement, hip resurfacing simply shaves and caps a few centimeters of bone within the joint.  The bone-conserving approach known as Birmingham Hip Resurfacing™ preserves more of the patient's natural bone structures and stability, covering the joint's surfaces with an all-metal implant. 

In May 2006 the FDA approved the procedure which has been successfully performed on more than 60,000 people worldwide since 1997. 

Tucson Orthopaedic Institute surgeon Lawrence R. Housman, M.D. explains, "Preserving bone is the key to preserving future surgical options for people. We are most concerned with active people under 65 who could face a second total hip replacement in their lifetime."  Dr. Housman is among the first surgeons in the U.S. to be trained in the Birmingham Hip Resurfacing procedure and has trained his colleagues in the procedure. 

Unlike total hip replacement, hip resurfacing patients can potentially resume the physical activities they enjoyed before hip pain limited their mobility.  In the first year following surgery, low-impact activities are recommended like walking, swimming and cycling.  After the first year, people may be able to return to higher impact activities like singles tennis or jogging. 

Hip Resurfacing
In hip resurfacing, the femoral head and neck are preserved. During the procedure, the surgeon removes a few centimeters of bone around the femoral head (the ball), shaping it to fit tightly inside a metal implant which then slides over the top of the ball like a cap on a tooth. 

The surgeon also prepares the acetabulum (socket) for the cobalt chrome cup that will form the socket portion of the ball-and-socket joint. The socket component is pressed into place similar to the standard total hip replacement. The two are then reconnected to restore smooth, low friction movement.

Total Hip Replacement
Total hip replacement surgery is a safe, effective procedure that is performed on over 300,000 each year in the United States. A second replacement, known as a revision, is generally more complex with a more difficult recovery.  

In a conventional total hip replacement, the femoral head and neck are removed and a metal hip stem is inserted down the shaft of the femur. The ball portion of the hip replacement is attached to the stem. 

Symptoms     
Osteoarthritis of the hip is the most common cause for both hip replacement and hip resurfacing. The first and most common symptom of osteoarthritis is pain in the hip or groin area during weight bearing activities such as walking.  People often limp to reduce the force on the arthritic hip.  As the condition worsens, the pain may be present all the time, even at night. Lifestyle modification, exercise and physical therapy, anti-inflammatory medications (NSAIDs), and over the counter medications such a glucosamine/ chondroitin may help to alleviate symptoms and are usually tried before deciding on surgery. Consult your health care provider for advice about your specific medical condition.

For more information on hip resurfacing or hip replacement surgery, please click here or contact the Tucson Orthopaedic Institute at (520) 784-6200. 

Birmingham Hip Resurfacing is a trademark of Smith & Nephew, Inc. Illustrations courtesy of Smith & Nephew.