Hip resurfacing

In January 2019, tennis player Andy Murray underwent hip resurfacing surgery in the hope it would end the hip pain he had experienced for a number of years.

While you may not be a world-class tennis player, if you have damage to your hip caused by arthritis or injury, your consultant may advise you to consider either total hip replacement surgery or hip resurfacing surgery.

What is hip resurfacing?

Hip resurfacing is an alternative to total hip replacement surgery. As the name suggests, it involves replacing only the surfaces of the hip joint rather than the entire hip joint itself.

The hip joint is termed a ‘ball-and-socket’ joint, a reference to the top of the femur (the ‘ball’) articulating with the acetabulum of the pelvis (the ‘socket’) to allow movement of the joint.

Traditional total hip replacement surgery involves replacing the arthritic hip joint with an artificial joint. This replacement joint is also known as a prosthetic joint.

In hip resurfacing surgery, the femoral head (the ‘ball) is reshaped and then has a smooth metal cap cemented onto it.

The surface of the acetabulum (the ‘socket’) has a metal implant attached securely to it. This ‘resurfacing’ helps to restore friction-free and painless movement and mobility of the hip joint.

Generally, hip resurfacing is advised in younger patients, as their bones are often more suitable for the resurfacing procedure.

Less bone is removed than with total hip replacement surgery and it can help to extend the life of the natural hip by a number of years without the need to completely replace the hip joint.  

For hip resurfacing surgery, you will be given a general anaesthetic, meaning you will not be conscious during the operation. Your surgeon will make a precise cut to give them access to the hip joint.

The head of the femoral bone (the ‘ball’), is then reshaped using specialised surgical tools to allow the fitting of the metal cap of the top of it. The cap is fixed securely in place using a surgical cement. The cartilage that lines the acetabulum (‘socket’) is removed and replaced with a metal cup.

The hip joint will be tested for range of motion and stability before the surgeon stitches up any incisions made and places a wound dressing over your hip. Sometimes a small tube will be placed in your hip following surgery; this is known as a ‘drain’, as its function is to drain any excess fluid and/or blood from the site of the surgery to help reduce swelling.

Following your surgery, you will be taken to the recovery room, where out theatre staff will monitor you carefully while you wake up from the anaesthetic. Once you have fully woken up and the theatre recovery room staff are happy with your blood pressure, heart rate and oxygen levels, you will be taken back to your ward to rest.

Within a day or two of your surgery, our physiotherapists will help you to start your rehabilitation by showing you how to get up out of bed and to walk safely. At the beginning of your recovery, you may need the use of a walking stick or frame to help you remain stable, but you will soon notice improvements in your strength and ability to move safely. 

Your safety is always our priority and we will only discharge you when you can walk safely with two walking sticks, including going up and down a flight of stairs.

Hip resurfacing surgery is a major procedure and it is important not to underestimate the length of time it can take you to fully recover.

Our Hip Clinic team, including consultants, nurses, physiotherapist and occupational therapists, will talk with you about what you can and cannot do while you recover.

Once you have returned home, you will need to be sensible in what you do as there will be certain physical limitations while you recover from the surgery.

Like all surgical procedures, hip resurfacing surgery carries risks and the potential for complications. Specific complications of hip resurfacing surgery include:

  • Infection in the hip joint,
  • Fracture of the neck of the femur,
  • Bleeding inside the hip joint,
  • Damage to the nerves near the hip joint,
  • Allergic reaction to the metal implants used to resurface,
  • Formation of a blood clot (known as a ‘deep vein thrombosis’ or ‘DVT’).

The above risks are intended as guidelines only and are not exhaustive. We always recommend that you talk with your consultant about potential risks and complications before you decide to have any surgery.

The consultant-led orthopaedic Hip Clinic at St Joseph’s has vast experience in carrying out hip resurfacing surgery.

Should you be experiencing ongoing and worsening pain or stiffness in your hip joint, please contact us to arrange a consultation with one of our hip specialists who will be able to give you expert guidance on whether hip resurfacing surgery would be of help to you.

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