Total hip resurfacing has been around since the mid 1990s in its current version. It was developed out of the necessity that young and active patients showed unacceptable high failure rates after total hip replacement surgery and that total hip replacement, not in all instances, allowed them to return to their active lifestyle. Over the last decade we have seen an increasing number of patients that come, sometimes in their 30s and 40s, to undergo hip replacement surgery and do wish to return to almost unlimited activities after their total hip replacement surgery. Total hip resurfacing might be an interesting treatment option for these patients. It, instead of removing the femoral head of the femur and implanting an implant into the femoral canal, only resurfaces the head and allows the surgeon to add a cap on top of the femur, replacing the diseased cartilage. This procedure does preserve bone on the femoral side and allows reconstruction with a relatively large head diameter, which increases the stability of the joint and decreases the risk of dislocation, especially for patients that engage in sports like rock climbing or full contact martial arts.
Hip resurfacing is a metal-on-metal bearing, which, in general, decreases overall wear and allows for repetitive high-impact sports with acceptable wear rates. However, metal ions can reach the blood stream and the metal ion levels in patients with hip resurfacing are usually increased. There is also the possibility that your body might react to metal ions and cause conditions such as fluid collections around the joint, synovial proliferations, or, ultimately, osteolysis and implant loosening. Because the incidence of these complications is higher in women, we currently do not recommend hip resurfacing for women. However, in young male patients, the risk of these complications seems to be in a range that is very similar to standard total hip replacement surgery within the first 10 years and, therefore, we do perform this procedure for patients that fit the indication criteria. Dr. Boettner will take time to discuss the pros and cons of resurfacing with you if you are interested in this procedure. He has, over the last six years, gained a significant experience in performing the surgery and has a large number of patients that have benefitted from this procedure. Dr. Boettner started doing hip resurfacings in December 2006.