Hip resurfacing An option for young & active patients with hip disease
Dr.A.K.VenkatachalamFRCS, MCh Orth, MS orth, DNB Orth
Consultant Orthopedic surgeonChennai, Indiawww.hipsurgery.in
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Rationale for Hip replacement & resurfacing Goal of any joint replacement is to
prevent bones without cartilage from grinding against each other.
Rubbing of raw bony surfaces causes pain.
Replacing the joint with a prosthesis abolishes friction and allows smooth & easy movement, removing pain.
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Goals of replacement & resurfacing To allow the patient to return to
many of their normal activities without pain and greater freedom of movement
To prevent further morbidity
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Hip resurfacing- Initial considerations Longevity of any primary THA
cannot be predicted Revision remains an issue
Young/active patient may outlive primary THA.
Hip resurfacing extends continuum of care in young patients with hip disease
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History of Hip resurfacing
1 st generation - Smith Peterson Mould
arthroplasty- numerous failures due to poor material
2nd generation- 60- 70’s Cemented
Metal on poly- Tharies- increased poly debris- HR abandoned almost entirely by 80’s
3rd generation 90’s - metal on metal hybrid arthroplasty Wright medical hip
Amstutz first Hip resurfacing – 1996.
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Candidates for hip resurfacing Young & active patients with hip arthritis
or secondary osteo-arthritis avascular necrosis ankylosing spondylitis post traumatic arthritis DDH Slipped capital femoral epiphysis Primary OA in young patients
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Surgical techniqueFemoral reaming
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Technique- Femoral head cemented in
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Acetabular reaming & component insertion
Uncemented cup Fixationby
circumferential fins (Durom)
Hydoxy apatite coating
Cobalt chrome molybdenum
High carbon content
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Post op x ray Proper position of
femoral component
Proper inclination of acetabular component
Proper depth of acetabular cup
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