Bone-Sparing, Total Hip Resurfacing Arthroplasty Surgery (Metal-on-Metal Device)
Last updated Friday, January 18, 2008
About the procedureTechnical details After the anesthetic has been
administered and the hip is prepared, the surgeon makes an incision. Most
surgeons approach the joint from the posterior (rear); others prefer a lateral (side)
or anterior (front) approach. During the posterior approach, fibers of the gluteus
maximus muscle are split. The tendinous insertion of the gluteus maximus is
recessed or divided to allow movement of the femur bone.
The interval between the gluteus
minimus and the superior acetabulum (hip socket) is developed and the
piriformis tendon is released from its femoral attachment. A 360-degree
capsulotomy is then performed.
The acetabulum is prepared. Bone
spurs are removed. Reamers are used to enlarge the acetabulum in preparation
for placement of the cup, whose position is crucial for a successful outcome.
The cup is impacted into place.
The femur is prepared by using an
alignment guide. A guide wire ensures that the spherical metal cap is
positioned correctly on the femoral head. The surgeon, with a chamfering
router-like instrument, removes only the outer layer of the femoral head, so
that the cap will fit snugly (IMAGE 4).
After the femur has been prepared, cement is mixed and the femoral cap component
is impacted into place, also secured by a metal stem that extends into the
femoral neck. (The femoral neck is left intact.)
With the femur and acetabulum completed, the hip
joint is re-established (IMAGE 5)
and taken through a range of motion to test stability. The soft tissues are
repaired, and the remainder tissues are closed, in layers, and a dressing
applied to the wound.Anesthetic Hip-resurfacing
surgery can be performed under a general anesthetic or under a regional block
(epidural or spinal). A spinal block can provide anesthesia for several hours
after the surgery. The patient may wish to discuss their preferences with the
anesthesiologist before surgery.Length of total hip resurfacing arthroplasty The
procedure usually takes about two hours, however the preoperative preparation
and postoperative recovery may add several hours of time. Patients often spend
two hours in the recovery room and, on average, three days in the hospital after surgery.Surgery for Total Hip Resurfacing Arthroplasty at the University of Washington If you are interested in making an appointment to discuss this procedure, you can request an appointment using our online referrals website. To request a referral online, please click here. You can also call 206-598-4288 (outside the Seattle area: 800-440-3280) to make an appointment.
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