Name of the Procedure:

Metal-on-Metal Total Hip Resurfacing

Common Name(s): Hip Resurfacing Technical/Medical Term: S2118 - Metal-on-metal total hip resurfacing, including acetabular and femoral components

Summary

Hip resurfacing is a type of hip surgery where the damaged surfaces of the hip joint are replaced with metal components. Unlike traditional hip replacement, where the entire femoral head is removed, hip resurfacing retains more of the patient's bone.

Purpose

Hip resurfacing is primarily used to treat advanced hip arthritis in younger, active patients. The goal is to relieve pain, improve hip function, and preserve more bone compared to a traditional hip replacement.

Indications

• Severe hip pain and stiffness due to arthritis or joint damage
• Patients who are younger, active, and have good bone quality
• Patients for whom a conventional total hip replacement might result in a higher risk of dislocation or other issues due to high activity levels

Preparation

• Fasting and medication adjustments as instructed by your surgeon
• Preoperative physical examination and assessment
• Imaging tests like X-rays or MRI to evaluate hip joint condition
• Blood tests and other routine pre-surgical evaluations

Procedure Description

1. Anesthesia: General or spinal anesthesia is administered to ensure the patient is pain-free.
2. Incision: A surgical cut is made to access the hip joint.
3. Bone Preparation: The femoral head and acetabulum (hip socket) are prepared by removing damaged cartilage.
4. Component Placement: Metal components are placed onto the femoral head and inside the acetabulum.
5. Closure: The incision is closed with sutures or staples, and a bandage is applied.

Tools and Equipment: Surgical instruments, metal resurfacing implants, imaging equipment for guidance.

Duration

The procedure typically takes about 1.5 to 3 hours.

Setting

Hip resurfacing is generally performed in a hospital or specialized surgical center.

Personnel

• Orthopaedic Surgeon
• Anesthesiologist
• Surgical Nurses
• Surgical Technicians

Risks and Complications

• Common: Infection, blood clots, pain, or hip dislocation
• Rare: Metal ion release, osteolysis, femoral neck fracture
• Management: Monitoring, medications, potential revision surgery

Benefits

• Pain relief and improved hip function
• Preservation of femoral bone
• Potential for greater range of motion and higher activity levels
• Benefits are often realized within a few weeks to months post-surgery

Recovery

• Hospital stay of 1-3 days
• Physical therapy starting immediately after surgery
• Gradual return to normal activities over several weeks
• Follow-up appointments for progress monitoring
• Short-term use of crutches or a walker is common

Alternatives

• Total Hip Replacement: More invasive, suitable for older or less active patients
• Medications: Pain management, anti-inflammatory drugs
• Physical Therapy: Strengthening and flexibility exercises
• Corticosteroid Injections: To reduce inflammation and pain temporarily

Pros and Cons:

• Total Hip Replacement: Longer-lasting but more invasive
• Medications and Injections: Non-surgical but temporary relief

Patient Experience

During the procedure, the patient is under anesthesia and should not feel pain. Post-procedure, patients may experience pain and discomfort, managed with medication. Physical therapy will aid in regaining strength and mobility, and most patients can resume normal activities within a few months.