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Caution Advised with Hip Resurfacing

Results of this study suggest there is still a high failure rate with hip resurfacing. This is true despite changes in the way the procedure is done. Surgeons from the Center for Hip and Knee Surgery in Indiana report long-term results of 62 patients.

Each one had an Indiana conservative hip prosthesis. This is a type of surface replacement that is no longer being used. Some of the problems with this prosthesis have been improved with newer designs.

But femoral failures may still be a problem with hip joint resurfacing that hasn’t been addressed. The authors advise caution before adopting hip resurfacing as a better choice over total hip replacement.

The results of this study show femoral neck fractures and femoral implant loosening two or three decades later. These problems may not have been corrected with the newer hip resurfacing techniques.

Most of the changes in today's hip resurfacing address problems with the acetabular (socket) side of the hip. Metal-on-metal now replaces the plastic liner to avoid failure from polyethylene wear. The components are placed into the bone without cement, which has helped with the problem of loosening.

The authors conclude that even though hip joint resurfacing helps preserve bone, failures are still too common to adopt this as a routine procedure. Comparing joint resurfacing with total hip replacement (THR) shows better long-term results with the THR.

References: Merrill A. Ritter, MD, et al. Failure Mechanisms of Total Hip Resurfacing. In Clinical Orthopaedics and Related Research. December 2006. No. 453. Pp. 110-114.

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