Hip Replacement Surgery
Replace Your Hip and Become More Active
An alternative for total hip replacement surgery is hip-resurfacing. In the WALL STREET JOURNAL (June 4), Anne Tergesen details new findings. Re-surfacing of the hip is an attractive alternative for people because the amount of surgery is less, healing is faster, and cost the same as in total replacement. Enthusiasm has been high. Since 2006 when they started offering them, 5% of first time hip surgeries are now re-surfacing procedures. A younger person needing a hip repair would prefer it to replacement since they can last only 10-15 years and then need reworked. Re-surfacing might buy time for the younger boomer. Get re-surfaced first and then get a total hip later if needed. In addition, it was thought people would regain their preoperative activity level sooner. A 2008 study showed that the surfers had higher activity scores than the total hip patients. Surfers announced it wide and far on the internet sites. More recent data holds that is not the case. Each does just as well. Activity levels at one to two years post operatively were found to be the same in a Canadian study of 107 patients. Mayo Clinic data demonstrates the same findings after one year. Higher activity levels touted by the surfer group are not true.
Some studies demonstrated superior results with re-surfacing over total hip replacement. However, recent studies are finding higher complications, especially in women. The numbers of procedures have dropped because of this. In addition, more durable hardware has been made for hip replacements and has improved their functional longevity.
In re-surfacing, the ball of the femur is cleaned off and kept. In a total hip, it is removed and replaced with an implant. The surgery for a re-surfacing is longer, uses a longer incision and is more difficult for the surgeon.
The dilemma occurs for women who seem to have more problems with the procedure. Women under the age of 55 had a higher incidence of a second operation within 5 years of their re-surfacing surgery compared to women undergoing a total surgery. Only men over 65 had similar problems. This gender related problem may be due to smaller size, and frail bones due to low bone density. Fracture of the femur head may thus occur and lead to the higher incidence of problems. This data has led to a re-thinking and re-assessment of the surgery for women. Some surgeons simply go case by case with no hard rules yet made, but do offer the method in younger women who have better bone density.
June 14th, 2009 at 12:05 pm
I have had both hips cleaned as described in this article. They both had better movement but most of the pain was still there. The surgery and recovery was very rough for me as I was a very young boy. I was in 7 the grade when I had my first surgery on my right hip and then later the next year I had the right hip done. The damage to my hips was a result of arthritis. The surgeries were way before time that artificial hips were available. I had my surgeries done in Oklahoma City through Mc brides Clinic at the Bone and Joint Hospital. Later the next year I had to have my right hip done again .I also had a problem eith my right hip atrophying and as a result my right leg was shorter than my left. Later in 1998 I had both my right and left hips replaced with total hip replacement surgery’s. That was the best thing that I have ever done to stop the pain and get movement in my hips. It now is 11 years later and at 51 years old my hips are still doing great. Not any pain like there was after the first 3 surgeries that I had (after all the rehab was done that is). I also had my left shoulder replaced in 2005. and 6 months later surgery to fix my right shoulder as it developed a rotator cuff problem. At that time they cleaned up my right shoulder bones while they were in there. The rehab for both shoulders was the most pain I was ever in including all my hip problems. Now in 20098 I still have lots of problems with my right shoulder and wish that they would have replaced it then instead of just cleaning it as it was in bad shape then. I don’t know if this will help anyone but I thought I would leave you with this info. I hope that ir may help someone that may be thinking of what they need to do for their problems.