What are the results of Resurfacing Hip replacement?

Medium-term results of Hip Resurfacing in a young patient population are very encouraging.

In one study⁽¹⁾, 294 Corin Hip Resurfacing operations were followed up from March 1994. The mean age of the patients at operation was 52.9 years. If failures due to infection are ignored as per the NICE (UK National Institute for Clinical Excellence) guidelines, the survivorship (the percentage of patients whose implants are functioning and have required no further surgical intervention) at six to seven years was 98.6%, which is well within the NICE guidelines and can be considered excellent given the young patient age group.

The long-term results of this procedure are not known as it has only been in clinical use in its current form since 1991. The results over this period have been very good, and are comparable with the best of other types of conventional hip replacement. There is therefore an element of the unknown - the long-term reliability of the implant will not be known until it has been in widespread use for 15- 20 years.

Reference

1. McMinn D, Pysent P. Metal/Metal Hip Resurfacing With Hybrid Fixation: Results of 1,000 cases – a personal series. Trans American Academy of Orthopedic Surgeons, 2001, San Fransisco

What are the disadvantages of a Resurfacing replacement?

The main disadvantage lies in not knowing the long-term results. The results so far indicate that the success rate of resurfacing replacement after the first five to ten years are comparable to those of routine Total Hip Replacement (THR). The operation is carried out in very much the same manner as a conventional THR.

The usual risks associated with hip replacement therefore apply. There is a very low risk of major complications due to infection or early loosening, leading to the need for further surgery. There is also a very low risk of medical complications associated with any major surgery of this type. Dislocation is less likely for this type of replacement than with THR. There is a small risk of the femoral neck fracturing after surgery - a slightly higher risk than for a standard hip replacement, but easier to deal with surgically.

Who is a Resurfacing Hip replacement suitable for?

This operation is primarily intended for use in younger people who need a hip replacement. There are certain causes of arthritis of the hip which mean that this implant cannot be used – such as those which have resulted in major deformity of either the head of the femur or the acetabulum. For people under the age of 55 needing a hip replacement, Hip Resurfacing should be considered. People aged between 55 and 65 who are very active and otherwise fit, may also be suitable. It is unusual to consider it for people over the age of 65, because a conventional type of hip replacement in somebody of this age group stands an extremely good chance of lasting them the rest of their lives. In patients who need to have hip replacements under the age of 50 - 55, assuming they have a normal life span, there is a very high chance that a conventional THR will wear out and need to be replaced during their lifetime. It is in these patients that Hip Resurfacing offers significant advantages.