Hip Resurfacing: Is It Better?

Those who have been worried about the health consequences of metal-on-metal total hip replacements may have an alternative in the form of hip resurfacing, a technique that has been available since 2006. However, evidence shows that while the technique has several advantages over total hip replacement, it results in the same problems.

The primary advantage is that a greater amount of the patient's natural bone can be preserved. With a total hip replacement, the entire top of the patient's femur (the femoral neck) must be removed. A metal head with a long shaft is implanted deep into the patient's thigh. In a resurfacing procedure, only the knob of bone at the top of the femur (the femoral head) is replaced (see diagram at the top of the page).

The new hip joint is stronger and more closely resembles and functions like the natural hip. When revision surgery is needed (which is usually the case, particularly with younger patients), it is much easier to do.

The same problems remain, however. Aside from femoral fracturing and the fact that these devices can also become loose over time, metal wear is still an issue. The same health problems result from the deterioration of the device – including metallosis, pseudotumors, and lymphocytic lesions. In fact, DuPuy manufactured a resurfacing device that was voluntarily recalled in August of 2010 after reports from U.K. (where the technique was first developed) indicated that an unusually high number of patients required revision surgery.

In the meantime, the California Technology Assessment Forum, a research group financed by Blue Shield of California, has reversed its formerly favorable position on hip resurfacing in light of evidence over premature failure and the release of metallic debris into patients' bodies.

Sources

McMinn, Derek M.D. "The Birmingham Hip Resurfacing." The McMinn Centre  (http://www.mcminncentre.co.uk/birmingham-hip-resurfacing.html ) Retrieved 31 Oct 2011.

Meier, Barry. "Hip Surgery Option Loses Key Backer." New York Times, 20 Oct 2011.

Image Credit: Patricia Walter, Hips For You. Released into public domain on 1 Dec 2007.

Learn more about DePuy Hip Replacement