Hip resurfacing
One particular type of hip replacement that has attracted a lot of publicity over the past few years is Hip Resurfacing Arthroplasty (HRA). In HRA, instead of the bone of the ball of the hip joint (the femoral head) being cut away completely and replaced with a new ball, the surface of the femoral head is shaved off, and a new dome-shaped surface is attached onto the top instead. This metal dome is fixed into a large metal socket in the pelvis.
Some of the potential advantages that it was thought that hip resurfacing might have over traditional hip replacement are that a) the ball part of the joint is larger and therefore potentially more stable, and less liable to potential dislocations, and b) less bone is removed, meaning that future potential revision surgery may be technically easier.
However, there are significant potential disadvantages with hip resurfacing. First, it relies on a metal-on-metal bearing, which may be a particular problem in people with metal sensitivity. Second, there is a risk of the femoral neck (the bone beneath the ball part of the joint) fracturing either during or after the operation.
Recent alerts have been issued, raising concerns over the results of metal-on-metal hip bearings, which includes hip resurfacing, with higher early revision rates being reported, with some cases of severe allergic reaction to the metal particles, and with a worrying number of patients forming cystic soft tissue masses in an around the hip joint (referred to as pseudotumours).
Given the worrying issues that have recently now been highlighted with this technique, we do NOT recommend or advocate hip resurfacing as an appropriate treatment option for our patients.
For further information on this subject, please click on this link to the British Orthopaedic Association website:-
http://www.boa.ac.uk/en/publications/mhra-alerts/
Or CLICK HERE to download a BOA advice sheet.