Hip Resurfacing

Maintaining an active lifestyle can be difficult when hip pain interferes with the majority of daily activities. The most common cause of hip pain is osteoarthritis, also known as “wear-and-tear” arthritis. Osteoarthritis is a degenerative joint disease in which the protective cartilage wears away and exposes the ends of the bones, creating narrow spaces and rough surfaces between the bones of the hip joint.

The hip is the most important weight bearing joint in the body, and any damage to the joint's components can cause severe pain symptoms during even basic movement, such as walking. For patients experiencing severe pain symptoms or noticeable decreases in activity level, Dr. Pritchett will often recommend surgery. For some patients, this may mean total hip replacements. For other patients, hip resurfacing may be an option.

How Hip Resurfacing Differs from Total Hip Replacement

Hip resurfacing is a surgical procedure that involves reshaping and covering the head of the thighbone (femoral head) with a wear resistant cap. The procedure also includes the placement of a new surface in the socket. In comparison, total hip replacement involves the complete removal of the head of the thighbone.

Dr. Pritchett will often use state of the art surgical techniques for hip resurfacing surgery.

Hip resurfacing is typically recommended for younger patients with strong bones. Patients under the age of 65, those who actively participate in athletic activities, and those who have good bone quality, benefit the most from hip resurfacing. Men and women can both benefit from hip resurfacing. Typically women are just as good a candidate for hip resurfacing as men.

Based on a comprehensive evaluation of the joint damage, Dr. Pritchett will determine the best treatment option to help each patient return to their daily activities as soon as possible.

Potential Benefits of Hip Resurfacing

Hip resurfacing techniques allow Dr. Pritchett to preserve as much of the bone of the joint as possible, by reshaping (instead of removing) the head of the femur. The benefits of hip resurfacing compared to traditional total hip replacement include:

• A more natural fit of the joint components post-op
• Reduced risk of dislocation due to a more natural size implant
• Greater range of motion, stability, strength, and a more natural walking pattern post-op
• Quicker return to an active lifestyle

Machine (Robotic or Computer) Assisted Hip Resurfacing Procedure

Recent technological advances allow surgeons to perform efficient and accurate surgical procedures than ever before. Machine-assisted surgery is a surgical technique used during joint replacement and resurfacing procedures. Traditional hip replacement and resurfacing procedures are completed through a larger incision, but with the addition of machine assistance, the procedure can be completed with greater precision in situations where traditional planning of the procedure was not as accurate due to deformity of retained implants from prior procedures.

During a machine assisted hip resurfacing procedure, Dr. Pritchett will insert special tracking devices into a small incision in the pelvis that calculate the precise position of the damaged areas. A computer screen in the operating room will display an interactive model of the patient’s hip joint, which provides Dr. Pritchett with precise measurements and details of the patient’s anatomy.

By using sophisticated surgical techniques, Dr. Pritchett can typically improve outcomes over prior methods. Computer assisted surgical techniques have advantages in instances where traditional planning processes are not accurate. Certain deformities make conventional templating not as useful. Machine assisted surgery allows for better planning by providing Dr. Pritchett with comprehensive data during surgery. This helps to determine the exact placement of the prosthesis.

Accurate placement of the prosthesis should decrease the amount of wear on the joint postsurgery, decrease the likelihood of dislocation, and extend the life of the implant. The benefits of modern surgical procedures include: less scarring, less disruption of the surrounding tissue during surgery, shorter rehabilitation period, short hospital stay, and more natural hip movement.

Recovering from Hip Resurfacing

To ensure a proper post-surgery recovery, patients will typically be required carefully observe all postoperative instructions. Hip Resurfacing is performed as an outpatient (surgery and discharge on the same day) basis. Patients are able to start putting weight on their leg right away, but will often require the assistance of crutches or a cane for a week or so as they regain their balance.

Common concerns after hip resurfacing surgery include the following:

• Fever - Most patients run a fever in the initial recovery period after hip resurfacing. We think this is from the release of cytokines (pyrogens) from drilling into the femur. Rarely is the fever a sign of infection or other serious complications. The usual pattern is for the temperature to rise later in the day or evening. The fever goes away within a few days
• Swelling - Most patients have significant thigh swelling after hip resurfacing. This is from dislocation the hip and often is a major inconvenience. It does not come on immediately following surgery but is usually present within the first several days. Ice, massage, and elevation may help.
• Wound Drainage - There often is drainage from the incision. Initially, the drainage is blood, but later it is just the serum, which is more yellow in color. Sometimes drainage occurs several days following surgery. If there is significant redness along with the wound drainage, Dr. Pritchett should be notified so that he can examine the incision for the possibility of infection. However, infection is rare.
• Muscle Spasm - Many patients are surprised that the major muscle pain is not in incisional area, but rather in the thigh. This can be a major inconvenience, but it does gradually subside. Exercise, massage, and ice can all help.

Dr. Pritchett will create a custom schedule on how to gradually incorporate flexibility and strength exercises into daily activity. Both at-home and formal physical therapy will be required to make sure that the joint heals properly.

Hip Resurfacing in Seattle, WA

Dedicated to using the most advanced techniques, James W. Pritchett, MD is one of Seattle's leading orthopedic surgeons. Dr. Pritchett specializes in the diagnosis and treatment of hip pain, including hip resurfacing. To learn more about the benefits of hip resurfacing, schedule an appointment with Dr. Pritchett at his Seattle office (206) 323-1900.