Hip Resurfacing vs Hip Surface Replacement
Hip resurfacing involves replacing damaged surfaces in the hip joint with metal surfaces. This procedure can be useful for patients under 65 with advanced hip disease
 
Hip resurfacing surgery is an alternative to standard hip replacements for patients with severe arthritis. In hip resurfacing surgery, the implant is smaller, and less normal bone is removed. Hip resurfacing is gaining interest, especially in younger patients
 
Mr Hugh Blackley was the first to pioneer modern hip resurfacing in New Zealand in 2003. He was trained by the designers and remains a strong advocate for the technique. He has done the most hip resurfacings of any surgeon in New Zealand and currently does 2-3 per week. He remains the most experienced surgeon in New Zealand in the procedure and is on the Australiasian Surgical Advisory Panel for Birmingham Hip Resurfacing.
 
Hip Resurfacing Anatomy

The hip is structurally complex. It is made of bone, ligaments, soft tissue, cartilage and muscle. The hip acts as a ball and socket joint. The femur or thighbone has a ball at the end of it which is called the head of femur. The socket forms part of the pelvis known as the acetabulum. For the hip to function well, a ball and socket joint is supported by a large muscle mass, known as gluteal muscle. Ligaments provide stability for the joint. Soft tissues, nerves and blood vessels provide the hip with nourishment sensation and protection.

The bones that comprise the joint are surrounded with a thin lining of cartilage. This cartilage is known as articulating cartilage, (cartilage that surrounds the bony surface). Articulating cartilage acts as shock absorber and enables the joint to move smoothly and painlessly in its range of movement. It is the wear and tear of these “shock absorbers’ that cause the problem. The Birmingham hip resurfacing seeks to improve the function of the hip, by resurfacing, or retreading the bone that has worn out its articulating cartilage. This eliminates the problem of pain caused by, worn out “absorbers’.

Diseased Hip Joint

The word arthritis literally means joint inflammation, (“Arth” joint, and “itis” inflammation). There are several forms of arthritis. Osteoarthritis is the most common form, and the hip is one of the common joints affected by this. Osteoarthritis especially affects the cartilage of the joints. It is a degenerative process, which directly results in the wearing out of the cartilage on the joint surface. Over time the joint surfaces slowly erode away until the underlying bone is exposed. Exposed bone results in a painful joint when it moves and bears weight. As hip pain and stiffness increase, you may find more and more activities you cannot attempt. The bones grate together. Other hip problems that produce similar symptoms include avascular necrosis (injury and loss of blood supply to the bones in your hip).

 

Activity modification, medications and physiotherapy can treat osteoarthritis conservatively in the short term. Long term relief however, requires surgical intervention.

There are two basic types of surgical treatment for advanced hip arthritis: Hip replacement and hip resurfacing.

In hip replacement where the ball and socket of the hip are replaced, because the ball (the top of the thigh bone) is removed it is replaced by a stem that goes down into the thigh bone to support a new ball. This stem maybe cemented into the thigh bone or uncemented (bone grows into the metal stem). One of the advantages of these stems is that we have been using them for 30-40 years and they are generally reliable, especially in older, less active patients. A disadvantage in younger active people is that they wear out an artificial hip (sometimes within 10 -15 years). As the artificial hip wears, bone is lost around the hip (osteolysis) and this causes stems and socket to eventually loosen and fail. Then they have to be replaced. When they are replaced they can be difficult to remove and require a longer stem to be inserted. Each time this means more thigh bone is damaged and eventually extensive bone graft replacements are need. The surgeries for this are much bigger and the results not as good as the first hip replacement. Eventually we may run out of bone for surgery meaning revision is not possible. This is not a major problem in older patients who do not wear out their artificial hips.

 
 
Further Information on Hip Resurfacing Surgery :

 

 

 
If you have any queries on Birmingham Hip Resurfacing Surgery please do not hesitate to contact Dr Hugh Blackley's practice rooms during office hours on 09 522 2980