Is an exciting new alternative to total hip replacement. Used successfully for years around the globe, the BIRMINGHAM HIP Resurfacing System has recently been approved by the Food and Drug Administration for use in the United States. Now, patients suffering from hip pain due to arthritis, dysplasia or avascular necrosis can benefit from its conservative approach to treatment.

Because this technologically advanced surgical procedure resurfaces rather than replaces the end of your femur, patients can participate in more strenuous physical activity with an implant that is potentially more stable and longer-lasting than traditional total hip replacements. And if future revision surgery is required, it may be a less complex and less traumatic procedure

Candidates

Hip resurfacing is intended for young, active adults who are under 60 years of age and in need of a hip replacement. Adults over 60 who are living non-sedentary lifestyles may also be considered for this procedure. However, this can only be further determined by a review of your bone quality. There are certain causes of hip arthritis that result in extreme deformity of either the head of the femur or the acetabulum (hip socket) where hip resurfacing is not an option.

Patients with primary osteoarthritis are ideal candidates.

Osteoarthritis of the hip is a disease which wears away the cartilage between the femoral head and the acetabulum, eventually causing the two bones to scrape against each other, raw bone on raw bone. When this happens, the joint becomes pitted, eroded and uneven. The result is pain, stiffness and instability, and in some cases, motion of the leg may be greatly restricted. Patients with osteoarthritis often develop large bone spurs, or osteophytes, around the joint, further limiting motion. Osteoarthritis is a common, degenerative disease, and although it most often occurs in patients over the age of 50, it can occur at any age, especially if the joint is in some way damaged.

Causes

Osteoarthritis of the hip is a condition commonly referred to as “wear and tear” arthritis. Although the degenerative process may accelerate in persons with a previous hip injury, many cases of osteoarthritis occur when the hip simply wears out. Some experts believe there may exist a genetic predisposition in people who develop osteoarthritis of the hip. Abnormalities of the hip due to previous fractures or childhood disorders may also lead to a degenerative hip. Osteoarthritis of the hip is the most common cause for both total hip replacement and hip resurfacing.

Symptoms

The first and most common symptom of osteoarthritis is pain in the hip or groin area during weight bearing activities such as walking. People with hip pain usually compensate by limping, or reducing the force on the arthritic hip. As a result of the cartilage degeneration, the hip loses its flexibility and strength, and may lead to the formation of bone spurs. Finally, as the condition worsens, the pain may be present all the time, even during non weight-bearing activities.

Before deciding on hip resurfacing, we try several non-surgical, conservative measures to relieve the pain and inflammation in your hip.

Lifestyle Modification

The first alternative to hip replacement involves such lifestyle modification measures as weight loss, avoiding activities involving long periods of standing or walking, and the use of a cane to decrease the stress on the painful hip.

Exercise and Physical Therapy

Exercise and physical therapy may be prescribed to improve the strength and flexibility of your hip and other lower extremity muscles. Your exercise program may include riding a stationary bike, light weight training and flexibility exercises. An aquatic therapy program is especially effective for the treatment of arthritis since it allows mild resistance while removing weight bearing stresses

Anti-inflammatory Medications

Arthritis pain is primarily caused by inflammation in the hip joint. Reducing the inflammation of the tissue in the hip can provide temporary relief from pain and may delay surgery.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) may be prescribed to decrease the inflammation associated with arthritis. A new classification of NSAIDs, called Cox-2 inhibitors, are often very effective in decreasing pain.

In a small number of cases, the doctor may prescribe corticosteroids, such as prednisone or cortisone, if NSAIDs are not effective. However, due to the higher rate of side effects associated with corticosteriods, a physician must closely monitor their use.

Glucosamine/Chondroitin
Two dietary supplements, Glucosamine and Chondroitin (commonly available in a combined tablet), may decrease the symptoms of hip arthritis. Glucosamine and Chondroitin sulfate are both naturally occurring molecules, and issues associated with both remain under active research. However, it appears that many people taking these nutrition supplements on a regular basis note a decrease in their arthritis symptoms.

There exist a number of non-surgical alternatives to total hip replacement surgery. Such measures as lifestyle modification, exercise and physical therapy, and medication should be implemented before deciding on surgery. If all of these measures have been exhausted then surgical intervention can be very successful in decreasing pain and greatly improving function.

Total hip replacement requires the removal of the femoral head and the insertion of a hip stem down the shaft of the femur. Hip resurfacing, on the other hand, preserves the femoral head and the femoral neck. During the procedure, we only remove a few centimeters of bone around the femoral head, shaping it to fit tightly inside the hip resurfacing implant.We also prepare the acetabulum for the metal cup that will form the socket portion of the ball-and-socket joint. While the resurfacing component slides over the top of the femoral head like a tooth cap, the acetabular component is pressed into place much like a total hip replacement component would be.