Report on Second Generation Total Hip Resurfacing Implants
In the last 10 years, surgeons have developed a new method to treat painful and disabling hip arthritis. Hip resurfacing arthroplasty is a type of hip replacement that replaces the arthritic surface of the joint. This method removes much less bone than the traditional total hip replacement.
In this article, Dr. T.P. Schmalzried from the Joint Replacement Institute in Los Angeles, California reports on second generation resurfacing procedures. Second generation refers to an improved line of implant devices.
Improved materials, cement, and techniques have taken care of many of the problems with the first generation resurfacing implants. The components are more durable now. They can be held in place without cement. There is a thinner metal-on-metal design. This makes it possible to save even more bone than with the first generation of resurfacing joint replacements.
Cementless fixation has reduced the risk of implant loosening. Replacing ceramic and polyethylene materials with metal has improved fracture rates. Using metal bearings has also decreased the squeaking that can occur with ceramic-on-ceramic implants.
More and more adults in their forties and fifties are seeking hip joint replacements. They don't want to be limited by the pain of hip arthritis. At the same time, they want to remain physically active. Hip joint resurfacing may be a good option for this group.
Careful patient selection is still the key to a good result. Men 55 years of age or younger have the best results. This is especially true if they have good bone stock, good biomechanics, and limited degeneration of the femoral head.
The outcomes of hip resurfacing are improved when there are no bone spurs increasing the risk of fracture at the head-neck junction. Postmenopausal women with low bone mass have the highest risk of hip fracture. Even with the new generation of implants, they are not always good candidates for hip joint resurfacing. Advancing age compounds these risk factors.
References: Thomas P. Schmalzried, MD. Why Total Hip Resurfacing. In The Journal of Arthroplasty. October 2007. Vol. 22. No. 7. Suppl. 3. Pp. 57-60.
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