Alternatives to Hip Replacement Surgery

Hip replacement surgery typically involves the surgical removal of the femoral head (ball) of the femur bone (thigh bone), together with the reconstruction and replacement of the acetabulum (socket) portion of the joint. This is usually done as treatment for end-stage degenerative arthritis, and the debilitating pain and mobility issues it causes.

Other Treatments Available

• Within the last 2 to 3 years, alternative surgical and non-surgical treatment options have become available to appropriate candidates. They are typically geared toward the younger, more active patient, but they are not exclusive to these age groups.
  If your arthritis is not yet so severe that replacement surgery becomes the treatment of choice, consider the following two alternatives as possibilities to remedy pain and mobility issues in mild-to-moderate degenerative arthritis.

"Scoping Out" the Problem

• One alternative treatment option is a procedure known as hip arthroscopy. It has become a valued treatment for a variety of hip pathologies, such as soft tissue injuries about the hip joint, as well as bone spur removal. This soft tissue pathology is called labral tear and consists of a tear in the soft, cartilaginous rim of the hip socket. This can occur by way of injury, aging and overuse. The rim of cartilage tears and can protrude into the joint itself where it can become lodged between the femoral head (ball) and the acetabulum (socket). This can cause considerable pain and mobility alteration.

Avoiding Large Incisions

• Hip arthroscopy involves the introduction of a rigid, fiber-optic lens into the hip joint through very small incisions, called "portals" and, after adequately visualizing any problem areas, performing a variety of therapeutic procedures (using specialized hand and power instruments), such as a labrum repair, removal of loose bodies within the joint, or shaving down and trimming any external bone spurs around the femoral head or rim of the socket that could be impinging upon movement.
  Hip arthroscopy can be a tremendous benefit for many patients, especially in the younger age brackets. It is minimally invasive, usually done primarily as an out-patient, and can significantly prolong the need for further, more invasive hip surgery.

Hip Resurfacing

• Another procedure that is relatively new in terms of available options, albeit more invasive, is the surgical procedure known as "hip resurfacing." This procedure does involve the surgical implantation of a metallic acetabulum (cup) and a metallic femoral head. It is, however, not considered a total hip replacement.

  Hip resurfacing is typically performed on the younger patient, and is not considered total replacement because, unlike the total hip where the ball of the hip is amputated from the femur bone, the femoral head is shaved down in a specific fashion to accommodate the metallic "cap." The socket is prepared to receive a polished metallic cup to accommodate the new "ball."
  The benefit of this procedure is the patient's own bone stock is not removed, rather just refashioned to accept new coverings, similar to capping a tooth.

Sometimes less, is more.

• According to the American Academy of Orthopedic Surgeons (AAOS), Hip resurfacing is an emerging alternative for treatment of advanced arthritis in the under-65 year old male and under-55 year old female. Your orthopedic surgeon can determine if you are a suitable candidate for this procedure.

  This procedure typically affects less of the patient's own bone stock, thus making it a more bone-conserving option. The anticipated rehabilitation time and post operative recovery is felt to be less because the construct is designed for a more rapid return to activity.

  Hip resurfacing procedures are currently being performed by appropriately trained orthopedic surgeons across the country in hospitals of all sizes where joint replacement surgery is commonly performed.