The orthopedic surgeons at Plaza Medical Center are among the most experienced in North Texas at performing a new procedure that relieves arthritic hip pain by shaving and capping a few centimeters of bone within the hip joint, rather than by replacing the joint.

“Hip resurfacing,” as the technique is known, leaves the native femur, or thigh bone, virtually intact. Instead of removing the top of the femur, the hip resurfacing approach covers the existing hip-joint surfaces with an all-metal implant. The implant looks more like a tooth cap than a conventional artificial hip.

Hip resurfacing significantly reduces the post-operative risks of dislocation and uneven leg length. In addition, the smooth and highly durable cobalt-chrome alloy used in the fabrication of the implant makes it likely to last longer than conventional hip implants that incorporate plastic components. Early testing suggests that these implants may last 10 to 30 years, although clinical data is needed to verify these tests.

Hip resurfacing is particularly well suited to the needs of younger patients (under age 60) who suffer from pain caused by degenerative processes within the hip joint, and for whom total hip replacement may not be appropriate due to the high levels of physical activity in which they engage.

While the implant used in hip resurfacing closely matches the size of a patient’s natural femoral head (hip ball), it is substantially larger than the femoral head of a traditional artificial hip. This increased size makes the replacement joint more stable, and reduces the chance of its dislocating after surgery.

Total hip replacement involves the removal of the entire femoral head and neck, while hip resurfacing leaves the femoral head and neck intact. The length and angle of the femoral neck are key factors in determining the natural length of a patient’s leg after surgery. Since the resurfacing procedure does not require the removal and replacement of the natural head and neck, symmetrical leg length is more likely to be maintained.

The hip-resurfacing implant consists of an all-metal ball and an all-metal socket. Traditional hip replacements use a metal ball and a plastic socket. Newer hip replacements also use the “metal on metal” bearing surface of hip resurfacing. Plastic sockets wear down over time - such wear is the leading cause of follow-up surgeries. All-metal total hip replacements reduce joint wear by more than 90 percent compared to total hip implants containing plastic sockets.

Frequently Asked Questions

“If hip resurfacing is so new, how can I be sure that it is a clinically proven technique?”

Hip resurfacing may be new to the United States, but it has been used with great success in other parts of the world since 1997. This means that there was no shortage of clinical data for the U.S. Food and Drug Administration (FDA) to review prior to its approving hip resurfacing for use in this country. The results in Europe have been excellent in a select group of patients.

“Who is a candidate for hip resurfacing?”

The typical patient will be physically active, under 60 years of age, and suffering from hip arthritis, hip dysplasia or avascular necrosis of the hip. The implant can be used in patients over 60 whose bone quality is strong enough to support the implant. Your surgeon will determine whether you are a candidate for hip resurfacing. Patients with very severe bone loss are not eligible for this procedure. Hip resurfacing is also not recommended for patients over 65 years of age.

“What are my physical limitations after surgery?”

It is likely that, after the first year, you can return to whatever physical activity you enjoyed before hip pain limited your mobility. This includes pastimes like jogging and tennis that must be permanently discontinued following total hip replacement. During the first year of recovery, low-impact activities like walking, swimming and bicycling are recommended for strengthening your femoral neck and the muscles around your resurfaced joint.

“How long will my scar be?”

Your surgeon will probably need to make an incision between six and eight inches in length, although in some cases a slightly smaller incision is possible. Although the incision is larger than that for minimally invasive total hip replacement, femoral bone is preserved for the future. Additionally, our doctors report that the pain after hip resurfacing is typically less than the discomfort after hip replacement.

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