Hip Resurfacing Offers Patients a Total Joint Alternative

Michael J. Anderson, M.D., Orthopaedic Surgeon, Columbia St. Mary’s

Posted: Oct. 1, 2006

Nearly 40 years ago, Columbia St. Mary’s began leading the way in joint replacement procedures by performing Wisconsin’s first total hip replacement at Columbia Hospital. This summer, our orthopaedic program presented another first – we are now the first and only hospital in Milwaukee to offer hip resurfacing as an alternative to total hip replacement surgery.

Traditional total hip replacement surgery involves removing the head of the femur (thighbone) and replacing it with a metal ball and socket that fits into a plastic liner in the pelvis. While this is still an outstanding treatment option for those with severe hip problems, hip resurfacing offers a solid alternative, especially for people who are young and relatively healthy. Energetic baby boomers under the age of 60 who plan to lead an active lifestyle for many more years are typically the best candidates for this procedure.

During hip resurfacing, the femoral head is not removed but rather reshaped and fitted with a cobalt chrome (high strength, surgical stainless steel) cap, which fits into a metal lining in the pelvis. This technique, known as Metal on Metal, typically results in far better wear and fixation of the hip joint, meaning the joint is more secure and wears at a significantly slower rate than metal-on-plastic joints.

The biggest benefit of hip resurfacing is the conservation of the femur bone, which decreases the likelihood of hip dislocation and produces an improved range of motion. Retaining as much of the patient’s native bone as possible also can be a distinct advantage for patients needing subsequent hip surgeries as they age. Recovery time is fairly comparable to a traditional hip replacement – usually six weeks to two months.

Because it is still major surgery, however, hip resurfacing does carry with it the inherent risks of any surgery – primarily infection, fracture of the femur or avascular necrosis (a disease resulting from loss of blood supply to the bones), although the possibility of these risks occurring is low.

Good candidates for hip resurfacing are generally younger, more active patients whose bone quality is good and without marked deformity of the hip (in order to withstand resurfacing of the femoral head).

For patients facing hip resurfacing, or any hip replacement surgery, I typically recommend having a full medical evaluation and an exercise plan in place (if pain allows) to achieve the best physical state possible before surgery. Many of my patients swim or bike as a way to strengthen the hip before surgery. Also, because of the innovative nature of hip resurfacing surgery, I recommend an institution such as Columbia St. Mary’s where the orthopaedic program has the expertise, experience and state-of-the-art technology to perform this procedure, as well as the pre- and post-operative care.

Another reason to consider Columbia St. Mary’s for joint replacement surgery is the innovative Joint Camp program. The philosophy of Joint Camp is that you are a healthy person who happens to have a bad joint. Operated by orthopaedic experts, Joint Camp is an educational program for patients before and after surgery. The pre-surgical curriculum includes information about the surgery, the hospital stay and recovery. Patients get to meet other patients that will be on the unit for joint replacement surgery. Post-surgical activities with Joint Camp can include individual and group therapy sessions, information about medications, exercise and follow-up care.

The Joint Camp team regularly incorporates many of the patient’s caregivers, including nurses, therapists, discharge planners, care coordinators and a personal “coach” – usually a patient’s loved one – who will be with a patient each step of the way. At Columbia St. Mary’s we have found this type of program a successful format for quicker recovery and overall positive patient attitude throughout the entire joint replacement experience.

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