Bone-Sparing, Total Hip Resurfacing Arthroplasty Surgery (Metal-on-Metal Device)
Last updated Friday, January 18, 2008
SummaryWhat are the key points about total hip resurfacing arthroplasty for total hip resurfacing arthroplasty?
Edited By: Jason S. Weisstein,
M.D, MPH Total hip resurfacing arthroplasty
is a bone-preserving procedure that helps restore comfort and function to patients’
hips damaged by degenerative joint disease (osteoarthritis, rheumatoid
arthritis, and traumatic arthritis), avascular necrosis, or developmental hip
dysplasia. It is viewed as an alternative to traditional hip replacements for
helping patients return to their active lifestyles.
There has been a recent surge in
interest in hip-resurfacing procedures.
Advocates have pointed to the bone-conserving nature of the procedure and
anticipated potential benefits related to post-operative activities and range
of motion. IMAGE 1 illustrates the difference in the
amount of bone removed for a resurfacing procedure versus a traditional total
hip replacement procedure. In this procedure, surgeons replace the acetabulum
(hip socket) in much the same way as a conventional total hip replacement but
the femoral head is resurfaced rather than removed (see VIDEO for more details).
Hip resurfacing is intended for
patients with high functional demands for whom traditional total hip
arthroplasty would be a poor option because of anticipated failure in the future
and subsequent revision surgery.
In these patients, the hip-joint
surface – the socket side on the pelvis, and the top end of the femur, which
fits into the socket – is destroyed by wear and tear, inflammation, or prior
injury (IMAGE 2). This leads to
stiffness, pain, and decreased ability to perform at work or enjoy leisure
activities such as sports.
The goal of hip resurfacing is to
restore the best possible function to the joint by replacing damaged joint
surfaces with artificial ones. After a clinical exam, an orthopaedic surgeon
with training in hip-resurfacing can help a patient determine if this procedure
would be helpful.
Modern hip-resurfacing systems
involve placing a non-cemented, porous metal cup into the hip socket and
cementing a metal cap onto the femoral head. This results in an articulating,
metal-on-metal surface (IMAGE 3).
Only as recently as May 2006 did
the FDA approve the first U.S.-available device for the procedure, manufactured
by Smith & Nephew. Its device has been implanted in about 80,000 hips worldwide
since 1997. A similar device made by Corin Group was approved for U.S. use in
July 2007, and other manufacturers sell such devices around the world.
Total hip resurfacing arthroplasty
is a technical procedure best performed by a surgical team trained in this
surgery. Such a team can maximize the benefit and minimize risks. The procedure
is performed under general or spinal anesthesia.
Many individuals are not appropriate candidates
for total hip resurfacing arthroplasty. For example, patients with poor bone
stock, significant avascular necrosis of the femoral head, kidney dysfunction,
infection, leg-length discrepancy, or women of child-bearing age may not be suitable patients for this
procedure. A thorough discussion with your orthopaedic surgeon is necessary to
determine whether this procedure is an option.
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.
How useful was this page or article?
|
|