Hip resurfacing, also known as hip resurfacing arthroplasty, is a form of hip
replacement surgery. In this procedure the damaged bone and cartilage of the hip
joint socket is removed and replaced in much the same way as in a total hip
replacement. The significant way that hip resurfacing differs from a total hip
replacement is that the head of the femur is preserved and capped rather than
removed. A hip resurfacing procedure may be considered when chronic hip pain
and disability have not responded to conservative treatment and interfere with
normal daily activities.
The hip joint is one of the most flexible joints in the body. It is located at the
meeting point of the rounded head of the femur and the cavity-shaped acetabulum
of the pelvic bone. The hip joint is a ball and socket joint with the rounded head of
the femur being the ball and the curved depression that is known as the acetabulum
being the socket. As one of the largest weight bearing joints in the body, the hip joint
is made to withstand the tremendous forces that activities such as walking, running
and jumping generate.
There are a number of conditions that can damage the hip joint and lead to
the need for a hip resurfacing procedure. The most common of these conditions is
osteoarthritis, which is a form of arthritis that is associated wear and tear on the
joints and is typically seen in individuals over the age of 50. In cases of
osteoarthritis of the hip, the articular cartilage covering the surfaces of the ball and
socket wears out leading to painful bone on bone contact. Symptoms of hip pain,
inflammation, stiffness, and impaired mobility arise. As the damage progresses the
symptoms increase in severity. Hip resurfacing is one of the procedures considered
to alleviate the symptoms and restore the consequences of osteoarthritis as well as
treatment for similar damage caused by other conditions including rheumatoid
arthritis, traumatic arthritis, avascular necrosis, and developmental hip dysplasia.
One of the benefits of a hip resurfacing procedure as compared to a standard
total hip replacement is the preservation of bone. Although the socket is treated and
replaced with a metal shell in a similar manner to a traditional total hip
replacement, the “ball,” which is head of the femur, remains relatively intact. Only a
little bone is trimmed from the head of the femur before it is capped with a smooth
metal covering. It is also thought that this procedure may reduce risk of post-
surgical dislocation since the size of the head of the femur with the cap more closely
resembles the size of the natural femoral head. Additionally, the procedure is easier
than a total hip replacement to revise if a second surgery is ever needed to replace
loose or worn out parts. Among the drawbacks of a hip resurfacing procedure is the
risk of fracturing the neck of the femur (requiring a total hip replacement).
Hip resurfacing is not suitable for all cases. In general resurfacing procedures
are more often a consideration in a young patient who has osteoarthritis and wants
to continue an active lifestyle.