Hip Resurfacing

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Hip Resurfacing: aka Replacing hip joints, partial hip replacement

 

 

 

What is it?

When a surgeon does hip resurfacing, he or she replaces the part of the joint that an arthritic surface, but removes a lot less bone than a total hip replacement.  Due to the fact that a hip resurfacing removes a lot less bone, it may be a surgery that is better for patients who are younger.  This is because they may need a revision of the replacement as they age. 

 

The Operation

There are a couple of different approaches that surgeons take to get to the hip joint. When the surgeon takes the anterior approach, it’s from the front of the patient’s hip.  The posterior approach comes from the back of the patient’s hip.  It’s important to note that there is no right or wrong approach, both of them are right.  The reason that surgeons favor the posterior approach is that it keeps the patient’s joint capsule intact.  This can help to reduce the risk of dislocation once the surgery is over, and minimizes the loss of blood.

The surgeon begins by cutting an incision along the side of the patient’s thigh. This will let the surgeon see both the patient’s femoral head and his or her acetabulum, which is the socket. The femoral head will then be taken out of the socket.  The surgeon then uses special powered instruments to shape the bone of the hip’s femoral head so that the metal surface of the prosthesis will fit on top of the bone snugly.

The cap will then be placed over the head that has been smoothed much like a tooth when it’s capped by a dentist.  The cap will be held in place with a small peg that will into the bone.  It’s important that the patient has enough bone that is healthy and can support the cap.

In some cases the patient’s hip socket remains unchanged, but it’s usually replaced with a cup that is thin and made of metal.  The surgeon will use a tool known as a reamer to remove the cartilage from inside the patient’s acetabulum and shape the hip socket to fit the component.   After the shape is right, the component will be pressed into place in the hip socket.  The metal liner will be held in place by friction until the bone has grown into the holes that re in the surface and attaches itself to the metal.

 

Alternatives to Surgery

 

While this type of surgery is an alternative to a full hip replacement, a full hip replacement is another option for patients to consider to replace hip joints.

 

 

 

Before the Operation

 

As patients have the best chances of a successful surgery when they are healthy, a modest weight and healthy laboratory work are often required prior to scheduling the surgery.

 

 

 

After the surgery - In the hospital

Once the surgery is complete, the hip will be covered with a dressing that is padded.  The patient’s feet will be placed in special stockings or boots and they will help prevent blood clotting.  The patient may find that there is a triangle shaped cushion that is between his or her legs - this keeps the patient’s legs from crossing.

 

If the patient was given general anesthesia, the patient will be visited by a respiratory therapist or a nurse to guide them through breathing exercises. The patient will use something called an incentive spirometer to help their breathing improve and avoid pneumonia.

While the patient is in the hospital, they will have physical therapy one to three times daily.  The first therapy session will be done not too long after the patient wakes up. 
The first thing that the therapist will do is to help the patient move from their bed to a nearby chair.  When the second day comes, the patient will be walking with crutches and for longer distances.  For the most part, it’s safe for a patient to put a comfortable amount of weight when walking or standing.   If a patient’s surgery was done without the use of cement, however, they will be instructed to limit the amount of weight that is put on the affected foot.

The therapist will give the patient exercises to use so that they start strengthening and toning the muscles of their hip and thigh.  Movements of the knee and ankle are used to assist in the pumping of swelling out of the patient’s leg and prevent blood clots from forming.  The therapist will also let the patient know which positions of the hip that they should avoid so that they don’t dislocate their hip.

 

 

 

After the Operation - At home

The patient is usually able to return home after spending between two to four days in the hospital.   The patient is sent home when they prove that they are able to get into and out of bed safely, walk up to seventy five feet with the walker or crutches, go up stairs and down stairs safely, and remember the hip precautions and use them. If a patient is unable to do the things safely, they may be sent to another unit until they are ready to go home and stay safe.  The external staples are removed two weeks after the surgery is done. 

Therapy is often continued once the patient returns home and they will be advised on when he or she will be able to resume normal activities. 

 

 

 

Possible Complications

All surgery carries some type of risk of complications. For hip resurfacing, here are the possible complications that patients may experience:

Complications from anesthesia
Thrombophlebitis

Infection

Dislocation

Fracture of the femoral neck

Inequality in leg length
Loosening
Bleeding

Clots

 

General Advice

Some patients find that this type of surgery is a better option than the total hip replacement.  It can be a great option for someone who is young and has problems with their hip.

 

 

 

Estimated Costs for Hip Resurfacing Surgery

 

Country Estimated Cost
USA $40,000
India $9000-15000
Malaysia $8000-12000
Singapore $10000
Thailand $9000-11000

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