About Hip Resurfacing

  In Total Hip Replacement procedures, the femoral head and neck (ball of the hip) is removed, and a stemmed implant (rod) is placed into the femur (upper thigh bone). The acetabulum (socket of the hip) is replaced with a metal shell and a plastic or ceramic liner. A new ceramic ball is placed onto the stem that is free to move within the new socket (acetabulum)

In Hip Resurfacing, the femoral head is not removed, but is instead trimmed of damaged cartilage and bone and an artificial surface (a cap) is secured over the top of the femoral head. The damaged bone and cartilage within the socket is removed and replaced with a metal or ceramic shell, just as in a traditional total hip replacement. 

 More normal walking pattern. 

Studies have shown that walking patterns are more natural following Hip Resurfacing compared to traditional hip replacement. Increased loading of the hip and improved push- off have also been seen in gait analysis.  Patients also report that the hip resurfacing feels very natural.

Increased stability and Increased Activity.   

Because the size of the ball and socket is similar to the original hip, the risk of dislocation is much lower for Hip Resurfacing in comparison to conventional Total Hip Replacement, even in activities that require a high range of motion such as surfing, tennis and football.

Hip Resurfacing uses impact and wear resistant bearing surfaces that are more suitable for higher activity demands.  This is true of the traditional Adept, metal-on-metal resurfacing implant and the new ReCerf implant. This, along with the preservation of bone means Hip Resurfacing patients are more able to return to activities such as  running and impact sports. 

Hip Preservation and Revision

A Hip Resurfacing preserves more of your natural bone. Because the components (called implants) used in hip replacements and hip resurfacing are mechanical parts, they can wear out or loosen over time and require a second operation called a revision. If revision of a hip resurfacing is required in the future, preserving this bone makes the procedure far easier and is similar to performing a standard total hip replacement.

Up until recently, hip resurfacing was reserved for young active males with a femoral head size over 50mm in diameter.  This was because high failure rates had been seen in metal-on-metal resurfacing in women and patients with small femoral heads.  With the introduction of ReCerf, a ceramic-on-ceramic implant, these limitations have been removed, and resurfacing can now be offered to all active patients.  The only limitations that remain are patients with Dysplastic (Abnormal shaped) hips or severe Avascular Necrosis where the bone of the femoral head has died and cannot support the resurfacing implant. 

With standard instrumentation, Hip Resurfacing has traditionally been performed through a posterior approach.  Although an excellent approach, this more invasive procedure requires detachment and then reattachment of muscle to bone and usually requires some precautions for several weeks following the surgery to protect this reattachment whilst it heals.

Using CT planning and 3D printing, Patient Specific Instrumentation (PSI) allows the Direct Anterior Approach (DAA) to be used to perform Hip Resurfacing. With minimal muscle disruption, the benefits of this less invasive approach include earlier return to activity and minimal post operative precautions.

With the introduction of ReCerf we now have options for implants as well.