Recent developments have made it possible for young, active adults with arthritis to have bone-preserving replacement surgery. The procedure is called a total hip resurfacing. This article presents a review of this concept.
Hip resurfacing involves smoothing down the uneven and damaged joint surfaces. Then a metal cap is placed over the head of the femur (thigh bone). A metal liner is placed inside the hip socket.
When hip resurfacing was first introduced, there were some concerns about the femoral head. Would the heat from the cement next to the bone damage it? Would the blood supply to the femoral head be cut off by the procedure?
Surgeons have studied these problems. They found ways to modify their techniques to keep this from happening. But long-term studies are still needed to show how the metal-on-metal hip resurfacing (MOMHR) holds up 10 and even 20 years later.
So far, five-year follow-up studies report a 98 per cent survivorship rate. Functional outcomes are excellent. Problems such as infection, loosening, and dislocation are rare. Plus the MOMHR gives patients a higher level of activity and greater range of motion when compared with a total hip replacement.
The authors advise that success with MOMHR depends on pre-operative planning. For the best results, the surgeon should create a template for each patient. The template is a clear plastic pattern used to determine the right size component to use. This is an essential step in preparation for hip reconstruction.