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Hip Resurfacing
Hip replacement has become necessary for your arthritic hip: this is one of the most effective operations known and should give you many years of freedom from pain. Once you have arthritis which has not responded to conservative treatment, you may well be a candidate for a resurfacing procedure of the hip.
A standard hip replacement replaces the acetabulum (hip socket) and the places a femoral component inside the femur (thigh bone) Hip Resurfacing or bone conserving procedure replaces the acetabulum (hip socket) in the same way but resurfaces the femoral head. This means the femoral head has some or very little bone removed and replaced with the metal component. This spares the femoral canal. Resurfacing procedures may be indicated in the young patient (usually less than 55years) who has osteoarthritis and wishes to maintain an active lifestyle. It is a more conservative and less traumatic alternative to Total Hip Replacement (THR).
Arthritis is a general term covering numerous conditions where the joint surface (cartilage) wear out. The joint surface is covered by a smooth articular surface that allows pain free movement in the joint. This surface can wear out for a number of reasons, often the definite cause is not known. When the articular cartilage wears out, the bone ends rub on one another and cause pain. There are numerous conditions that can cause arthritis and often the exact cause is never known. In general, but not always it affects people as they get older (Osteoarthritis) . Other causes include
In an arthritic hip
Diagnosis The diagnosis of osteoarthritis is made on history, physical examination & X-rays There is no blood test to diagnose Osteoarthritis (wear & tear arthritis)
Resurfacing procedures may be indicated in the young patient (Less than 55years) who has osteoarthritis and wishes to maintain an active lifestyle. It is a more conservative and less traumatic alternative to Total Hip Replacement (THR). Advantages The main advantage is that it is bone sparing in that it does not violate the femoral canal. This allows a Total Hip Replacement to be performed at a later date, if required with little difficulty.
Your surgeon will send you for routine blood tests and any other investigations You will asked to undertake a general medical check-up with a physician You should have any other medical, surgical or dental problems attended to prior to Make arrangements around the house prior to surgery Cease aspirin or anti-inflammatory medications 10 days prior to surgery as they Cease any naturopathic or herbal medications 10 days before surgery Stop smoking as long as possible prior to surgery.
An incision is made over the hip to expose the hip join The acetabulum (socket) is prepared using a special instrument called a reamer The acetabular component is then inserted into the socket. This is sometimes reinforced with A liner which can be made of plastic, metal or ceramic material is then placed The femur (thigh bone) is then prepared. The femoral head which is arthritic is The femoral component is then inserted into the femur. This may be press fit A trial reduction (putting the hip back into place) is performed to make sure The real femoral head component is then placed on the femoral stem. This can be made - The hip is then reduced again, for the last time - The muscles and soft tissues are then closed carefully.
You will wake up in the recovery room with a number of monitors to record Post-operative X-rays will be performed in recovery Once you are stable and awake you will be taken back to the ward. You will have one or two drips in your arm for fluid and pain relief. This will be explained On the day following surgery, your drains will usually be removed and you will be Pain is normal but if you are in a lot of pain, inform your nurse. You will be able to put all your weight on your hip and your Physiotherapist will help - You will be discharged to go home or a rehabilitation hospital approximately - Sutures are usually dissolvable but if not are removed at about 10 days. A post-operative visit will be arranged prior o your discharge. You will be advised walking with crutches two weeks following surgery and walking
Remember this is an artificial hip and must be treated with care. AVOID THE COMBINED MOVEMENT OF BENDING YOUR HIP AND TURNING
As with any major surgery, there are potential risks involved. The decision to It is important that you are informed of these risks before the surgery takes place. Complications can be medical (general) or specific to the hip Medical complications include those of the anaesthetic and your general well
Specific complications - Infection Infection can occur with any operation. In the hip this can be superficial or deep. - Blood clots (Deep Venous Thrombosis) These can form in the calf muscles and can travel to the lung (Pulmonary - Dislocation. This means the hip comes out of its socket. Precautions need to be taken with - Fractures (break) of the femur (thigh bone) or pelvis (hipbone) This is also rare but can occur during or after surgery. This may prolong your recovery, - Damage to nerves or blood vessels Also rare but can lead to weakness and loss of sensation in part of the leg. - Wound irritation Your scar can be sensitive or have a surrounding area of numbness. This - Leg length inequality It is very difficult to make the leg exactly the same length as the other one. Occasionally Leg length inequalities are less likely to occur with a resurfacing procedure. Wear All joints eventually wear out. The more active you are, the quicker this will occur. Resurfacing procedures should last longer, but this has to be proven by long - Failure to relieve pain Very rare but may occur especially if some pain is coming from other areas such - Unsightly or thickened scar - Pressure or bed sores - Limp due to muscle weakness Discuss your concerns thoroughly with your orthopaedic surgeon prior to surgery.
Surgery is not a pleasant prospect for anyone, but for some people with arthritis,
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