Hip Resurfacing vs. Standard Total Hip Replacement by Dr. Thomas Gross

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Hip Resurfacing vs. Standard Total Hip Replacement

Written June 6, 2011
(My bias is obviously as a hipresurfacing proponent)

HIP RESURFACING:

PROS                                                                         CONS
1. Less bone removal on the femur.                                1. Femoral neck fractures (1.5 %).
2. Rare dislocations (<0.25%)
(Equal to large metal bearing THR).
3. Unbreakable bearing surface / implant.
4. No thigh pain.
5. No femoral shaft fractures.
6. More patients able to resume high‐level athletics.

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Hip Resurfacing vs. Total Hip Replacement | Hip Resurfacing Patients Community

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Posted by Mark Bloomfield on hipsrus Message board on April 20, 2009

Have not been here for a while, but thought it time to post something, especially after attending the recent British Hip Society meeting in Manchester.

Which, by the way, was poorly attended by what would be regarded as the doyens of UK hip surgery. Mostly new consultants, registrars or other ‘training’ grades. Not sure why. Maybe everyone is feeling fatigued by the credit crunch, the declining state of the NHS etc.

I have now done over 1000 hip resurfacings. Practically all the Birmingham device marketed by Smith & Nephew. So I thought I would share what I think about the technique right now. This is not a scientific paper and the views expressed are my own. I suppose I could ‘prove’ most of what is written below by suitable references in the literature, but some is instinct or gut feel. So it could be wrong, but chances are high the views expressed are accurate!

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Benefits on Hip Resurfacing by Dr. Vijay Bose

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October 2005

Hip resurfacing is a technique invented specifically for younger patients with hip problems. Conventional Total hip replacement, while being a good option for an elderly person (above 70yrs) is a poor choice for young patients as it will fail rapidly. The hip resurfacing operation is an alternative to hip replacement and has 3 crucial advantages. The first is that no plastic (polyethylene) is used like in conventional hip replacement. Since a anatomical sized ‘metal on metal’ bearing is used it lasts for a very long time, manifold that of conventional hip replacement and is extremely popular in Europe, Australia and some parts of Asia. The anatomy and bio-mechanics after resurfacing mimic a normal hip very closely.

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Resurfacing vs. THR by Mr. Mark Bloomfield, Orthopaedic Surgeon UK

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November 15, 2008

The first point I want to make is I have done hundreds or thousands of total hip replacements (THR) on all sorts of people at all sorts of ages and activity levels. Some of this experience pre-dates hip resurfacing, but I still often do THR as well. There were many very happy THR patients, but quite a few with a host of problems. My patients and colleagues’ patients referred to me for a second, third or more opinion! Dislocation [sometimes occurring so often further surgery was required], infection, leg length differences and completely inexplicable pain. Another frequent problem was limping or muscle weakness as a result of using the direct lateral or Hardinge approach to the hip in an effort to avoid the higher dislocation rate associated with the posterior approach – which more rarely has muscle weakness or limp associated with it.

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Metal-metal Hip Resurfacing Offers Advantages

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Metal-metal Hip Resurfacing Offers Advantages Over Traditional Arthroplasty in Selected Patients

By Robert L. Barrack, MD
ORTHOPEDICS 2007; 30:725
September 2007

http://www.orthosupersite.com/view.asp?rID=23573

Total hip arthroplasty (THA) is among the most successful interventions in medicine. It is the best option for most patients with end-stage arthritis of the hip. However, THA has some limitations, and problems with THA are far from nonexistent. Revisions account for almost 20% of hip cases in the United States, and this number is growing.1 These revision cases pose a greater risk for patients.

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Hip Resurfacing vs. THR by Dr. Vijay Bose

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Birmingham Hip Resurfacing

from Dr. Bose website

  • Suitable for Younger Patients
  • Bone not removed
  • Articulation is metal with metal
  • ‘Everlasting’ – based on 35 year history in Birmingham of Metal on Metal Articulation
  • Activity restriction not required after surgery as there is hardly any risk of dislocation (can sit on floor, squat, use Indian toilet, etc.)
  • Sport and High demand activities encouraged as usage is not related to life of resurfacing implant
  • Revision surgery not Required for younger patients
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