Two months after I had my left hip joint resurfaced, I had to have it removed and a total hip done instead. Does this happen very often?

Studies show that complications after hip joint resurfacing range anywhere from zero to four per cent. Other studies support the idea that revisions of this type are caused by errors in surgical technique and patient selection.

For example, joint resurfacing is not advised in older, postmenopausal women. The bone is often osteopenic or osteoporotic (decreased mass) and may fracture at the femoral neck. Obesity is also a negative risk factor. Anyone with a BMI more than 35 is not a good candidate for this type of surgery.

Surgeons must be trained and experienced in using this technique in order to reduce the risk of fracture and other complications. Implant loosening, hip dislocation, and infection are the other most likely complications from this new procedure.

Other ways to avoid femoral neck fractures have been suggested. The implant must be positioned carefully. Any malalignment or imbalance can contribute to problems. Weak bone may not be able to support the implant with fracture as the result.

Most often complications are the result of several (if not many) factors combined together. The rate of complications declines with each surgeon with practice and experience. Patients with severe arthritic changes are usually treated with a total joint replacement, bypassing this step altogether.