Total Hip Replacement Surgery Vs. Hip Resurfacing

For those with severe arthritis in the hip or who have experienced a hip injury, surgery to replace the diseased joint most often involved an entire hip replacement. However, a new surgical approach called hip resurfacing is offering patients a new option in hip surgery. All patients may not be candidates for these procedures, therefore it is important to evaluate the risks and rewards.

What Is Hip Replacement?

• At its most basic description, hip replacement surgery involves removing the diseased hip joint and replacing the joint with a ball-and-socket joint that is made of plastic, metal, ceramic or a combination of these materials. A hip replacement can be performed through a variety of approaches, including open surgery, which requires a large incision, or minimally invasive surgery, which requires several smaller incisions.

What Is Hip Resurfacing?

• As compared to replacing the entire hip joint, hip resurfacing (which is also known as Birmingham Hip Resurfacing) involves shaving the femur head in order to place a metal cap over the femur. Then, the cap is anchored by a spike that is affixed into the center of the femur bone. The thigh bone is left intact. While this procedure does not remove the joint, it requires more room for a physician to maneuver, and may therefore take more time and require a larger incision.

Who Is a Candidate for Hip Replacement?

• Hip replacement procedures are an option for those with conditions such as osteoarthritis, rheumatoid arthritis, a broken hip, bone tumor or a condition known as osteocronosis, in which blood does not properly flow to the hip joint. These conditions cause severe pain and can restrict a person's activity to engage in even the most standard of activities, such as rising or walking. Because the hip joint is designed to last for 15 to 20 years at the most, according to The New York Times, patients are encouraged to wait as long as possible to undergo this type of surgery.

Who Is a Candidate for Hip Resurfacing?

• Hip resurfacing surgery is ideal for younger patients and those who are very active. It is not considered a substitution for hip replacement, but a way to conserve bone for the possibility of a future surgery. Hip resurfacing allows younger patients to experience pain relief, then undergo hip replacement surgery at a time when the hip replacement will last for the rest of his or her life. However, those with very severe arthritis, such as those in advanced age, may not be good candidates as the level of disease may not make resurfacing possible.

Risks of Each

• As with any joint replacement surgery, there are dangers that the implant will not function properly, of excessive blood loss, blood clotting or of lost range of motion.

  For the hip resurfacing surgery, the primary concerns are that the procedure is relatively new and has not been studied for its long-term effects. However, according to Zimmer.com, the femoral cap manufacturer, the mid-term results of this surgery have been "encouraging" as an alternative to hip replacement.

  For total hip replacement (particularly in comparison with hip resurfacing), one of the chief risks is that the implant will wear out. Because hip implants are both difficult to remove and replace, these hip joints should be strong enough to last the rest of the patient's life.