Hip resurfacing is a surgical procedure designed specifically for individuals with osteoarthritis or osteonecrosis on both sides of the hip joint (the ball and the socket). This procedure, often called metal-on-metal hip resurfacing, replaces the damaged cartilage of the socket with an all-metal cup, and covers the damaged ball of the hip with a metal shell much like a dental crown. It is usually indicated for younger, more active patients.
In resurfacing, the femoral neck is preserved rather than removed as is done in conventional stem-type total hip replacement. As a result, the bone is loaded more like a normal hip, and the bone is preserved. Since the resurfaced head is very similar in size to the normal hip, it is more stable and dislocation is unlikely. This allows the hip resurfacing patient to return to an unrestricted lifestyle.
The conservative bone removal of surface replacement has always been appealing to both surgeons and patients. The recent reintroduction of all-metal bearings has dramatically increased durability. It is unknown how long a hip resurfacing will last. This is more a function of stress and cycles of use rather than time. If revision of a hip resurfacing is required, the procedure is comparable to primary total hip replacement since the bone of the femur is intact.
Resurfacing vs. Replacement
Preserves the femoral head and neck and uses a bigger ball, reducing the chance of dislocation. Preserves the femoral canal.
Removes the femoral head and neck. Hollows out the thighbone and drives a stem deep into the femoral canal.