Hip replacement is one of the most common orthopaedic procedures performed in the United States. While this operation is very successful in the elderly population (age >65), unfortunately, the procedure has the poorest results in younger, more active patients with arthritis.
Total hip resurfacing arthroplasty is a new alternative to traditional total hip replacement. Jason Weisstein, M.D., MPH, FACS, of the Boca Raton Orthopaedic Group is a respected authority on the new technology and has performed more procedures using the total hip resurfacing technology than any other orthopaedic surgeon in Palm Beach or Broward County.
While this technology is new to the United States, the procedure is not new as it has been in use around the world since for over ten years. Floyd Landis underwent this procedure after the Tour De France and is actively participating in cycling races across the country. The excitement around this technology was recently covered in the Wall Street Journal as a very important development for younger patients with hip disease.
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.
This procedure preserves bone, restores comfort, and helps patients return to their active lifestyles. 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. 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.
Dr. Weisstein explains that the procedure offers distinct patient benefits. There is bone conservation, greater stability, decreased risk of dislocation, and the potential to allow patients to be more active than standard total hip replacement.
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.
Total hip resurfacing arthroplasty is a technical procedure best performed by a surgeon with substantial experience. Dr. Weisstein warns that the surgical learning curve is steep and that the procedure is more difficult than traditional total hip replacement
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.
Hip resurfacing may lead to a dramatic improvement in the quality of life of young, active patients who have advanced arthritis of the hip. When combined with a thoughtful rehabilitation program, total hip resurfacing arthroplasty allows patients with arthritic hips to regain comfort and function. The procedure has been shown in intermediate term studies (10 years of follow-up) to have met patient expectations, with an extremely low failure rate. Many patients have returned to pre-symptomatic levels of activities (sports, cycling, etc.) and occupation several months after this procedure.
In the hands of an experienced surgeon trained in hip resurfacing, total hip resurfacing arthroplasty is effective in restoring comfort and function to the hip of a well-motivated patient. A 2007 study of 59 hips reported significant improvement in pain, function, range of motion, and activity among patients who were, on average, six years postoperative. The study, published in The Journal of Bone and Joint Surgery by H.C. Amstutz and colleagues at the Joint Replacement Institute, reported five cases (8 percent) of femoral failure, requiring subsequent total hip arthroplasty. This and other studies have helped physicians better discern which patients have a better chance of a successful outcome.
Hip replacement is one of the most common orthopaedic procedures performed in the United States. While this operation is very successful in the elderly population (age >65), unfortunately, the procedure has the poorest results in younger, more active patients with arthritis. 
