The hip joint is the most flexible free-moving joint in the body, as well as one of the large weight-bearing joints. If any part of the hip is damaged or degenerated, movement can be limited. Even without injury, cartilage can crack and wear away in time. The ball of the hip joint begins to grind against the socket, bone against bone, causing stiffness and pain.
There are basically five main causes for hip degeneration and pain, Osteoarthritis, Rheumatoid Arthritis, Avascular Necrosis (AVN), Fracture/Dislocation and Developmental Dysplasia of the Hip.
Conventional Total Hip Replacement Arthroplasty is a very successful procedure for the treatment of hip arthritis, despite the extensive bone removal. It is indicated in older patient. For younger, more active patient needs a hip replacement that is durable and last longer. There is a high chance that a conventional hip replacement will wear out during their lifetime and need to be replaced again.
Orthopedic surgeons are turning to a new technique known as “Hip Resurfacing” as the effort to gain more physical activity to the patient. This bone-sparing procedure promises to last much longer than traditional hip replacements while allowing a great range of physical activity for the patient. Hip resurfacing gained popularity on the basis of assumptions about better clinical function and ability to return to a high level of activity.
“Hip Resurfacing” is a type of hip replacement which replaces the two surfaces of the hip joint. It is based upon metal on metal technology with large diameter of head component. The resurfaced metal on metal hip joint glides with a smooth, natural motion, with high stability. Metal on metal surface contact hip prosthesis have been shown to be significantly more wear resistant than the traditional metal on plastic surface contact hip replacement arthroplasty.
The resurfacing components are made of cobalt chrome which is finely machined to produce a very high quality surface with a low friction finish, hence low wear over decades of clinical use. The BIRMINGHAM HIP Resurfacing (BHR) has the largest independently verified clinical history of any resurfacing device available today.
Hip Resurfacing is very bone conserving procedure as the head and neck of the femur is retained. Instead of removing the head completely, it is shaped to accept an anatomically sized metal sphere. There is no large stem to be inserted down the central part of the femur and the surface of the acetabulum (the socket) is also replaced with a metal implant, which is press fit directly into the bone.
Who is a candidate for hip Resurfacing?
The procedure is primarily intended for use in people who are in need of a hip replacement at a younger under the age of 55. People aged between 55 and 65 who are very active and otherwise fit may also be suitable and this will be determined by their bone quality and activity level. The procedure should be considered in some people who have mild to moderate hip dysplasia.
Hip resurfacing has been shown to eliminate the problems of proximal femoral stress shielding and bone resorption caused by plastic wear debris associated with traditional plastic on metal total hip replacement. Hip resurfacing eliminates the problems of hip dislocation and significantly reduces the problem of leg lengthening.
The results at 10 years have been excellent and all at least as good as conventional hip replacement. However, the long term results of this procedure are not yet known as it has only been in clinical usage in its current form since 1997. The long term reliability of the implant will not be known until it has been in widespread usage for 15 to 20 years.