Hip resurfacing at York Hospital

What is hip resurfacing?

It’s used to treat hip pain, most commonly hip osteoarthritis. Unlike a total hip replacement, it retains more of the bone.

During the procedure, the damaged surfaces of the femur head (ball of the thighbone) and the acetabulum (socket in your pelvis) are reshaped and replaced with a cover.

Is hip resurfacing right for me?

If your hip pain or stiffness is restricting your day-to-day life and non-surgical options like physiotherapy and joint injections haven’t helped, you may be considered for hip resurfacing.

This procedure is usually only offered if:

• you’re under 60
• you have a strong, healthy thighbone
• you’re active.

What are the benefits of hip resurfacing?

Primarily, reduced hip pain. And because hip resurfacing restores the natural size and shape of your hip, compared to a hip replacement, it offers:

• better stability
• reduced risk of dislocation
• a broad range of movement
• higher levels of activity
• an easy revision, if a second surgery is needed in the future.

Will the benefits last?

It’s still a fairly new procedure, but so far it’s been shown to last just as long, or longer than traditional hip replacements.

What happens during hip resurfacing?

Hip resurfacing is usually done under spinal anaesthetic, but general anaesthetic could also be used - your anaesthetist will discuss your options with you. The operation usually takes 1–1.5 hours.

Before the procedure

There are a few things you can do in the lead up to the procedure to make sure everything goes as smoothly as possible:

• Let your doctor know about any medication you take and follow their advice
• Stop taking anti-inflammatory medications like ibuprofen and aspirin at least 7 days before your operation
• Exercise regularly
• If you smoke, stop smoking several weeks before the operation
• Don’t eat or drink for 6–12 hours before the surgery.

During the procedure

1. After you’ve been given the anaesthetic, your surgeon will make a cut on the outside of your hip and remove and clean the damaged joint surfaces
2. Then they’ll place artificial coverings on the ball and socket of the joint – these will either be fixed to the bone with acrylic cement, or have special coatings that bond directly to the bone
3. Finally, they’ll close the skin with stitches or clips and apply a dressing.

After the procedure

You’ll be taken to the recovery room, where you’ll wake up (if you’ve had general anaesthetic). A nurse will look after you and check your wound, blood pressure and pulse. When you’re ready, they’ll take you to your room.

Recovery

You’ll usually be in hospital for around 2 or 3 days. Most people make a good recovery and return to normal activities within 2 or 3 weeks.

Short-term recovery

When you’re back in your room, the nurse will keep checking on you to make sure you’re recovering well. Once the anaesthetic has worn off, you’ll be able to have something to eat and drink.

While you’re in bed, you may have help with the circulation in your legs to prevent blood clots. This can include:

• Wearing boots that are inflated with air for the first 2 days
• Wearing support stockings, which you should leave on for 4–6 weeks
• Daily injections or tablets, which you may have for up to 6 weeks

Walking around again

• Day of surgery: A physiotherapist will give you some exercises to do while you’re in bed to help your new hip joint move and strengthen the muscles.
• Day after surgery: The physiotherapist will help you get out of bed and take your first steps – you may need to use a frame to start with. The nurse will then help you walk around until you can do this yourself. You should repeat your exercises hourly.
• Second and third day after surgery: An occupational therapist will give you some tips for getting on and off the bed, chair and toilet, as well as washing and dressing. The physiotherapist will help you transfer to crutches or a walking stick, before giving you some more exercises to increase your movement.

You’ll be able to go home as soon as you can walk up and down stairs safely and the healthcare team are happy with your recovery.

You won’t be able to drive, so you’ll need someone to come and take you home.

Managing your recovery at home

You may be tired when you get home, so you should rest, but then it’s important to slowly increase your activity.

Here are a few things you can do to strengthen your hip, avoid damaging it and help your wound heal:

• Continue the exercises the physiotherapist showed you 3 or 4 times a day for 6 weeks
• Stay active, gradually increasing how far you walk each day
• If moving around is uncomfortable, take any painkillers we’ve prescribed until you’re pain free
• Avoid bending your hip beyond 90 degrees
• Avoid rolling your leg towards the other leg or crossing your legs
• Avoid twisting on your hip when standing
• Use the shower instead of the bath
• Keep using your crutches or walking stick for as long as you feel you need to
• Don’t fly for at least 3 months.

Call the healthcare team if you have any questions or concerns about anything.

Driving after hip resurfacing

We recommend you wait 6 weeks until you start driving again. Don’t drive until you’re confident you can control your vehicle and always check with your insurance company and your doctor.

Time off work

Most people return to work 6–12 weeks after the operation. If you have a manual job, then it may be around 3 months before you can return.

Follow-up appointments

You’ll need to come back about 2 weeks after your operation to have your stitches or staples removed. You’ll also need to see your consultant around 6 weeks after your operation for a check-up. We’ll arrange all of this with you before you leave the hospital.

Alternative treatment options

Most hip pain problems don’t usually require surgery and can be eased through non-invasive measures, such as painkillers, physiotherapy and joint injections.

If scans and X-rays have been inconclusive, a hip arthroscopy may be used to diagnose and treat hip pain.

A total hip replacement may be considered when other measures haven’t helped, and is usually only performed if you’re older or have a weak thighbone.

Risks

Complications are rare but possible. Rest assured that your consultant will weigh up the risks and advantages with you when deciding if they recommend surgery. Your consultant will also discuss any additional risks that apply to your situation at your initial consultation.

Complications of hip resurfacing are rare, but you could experience:

• Infection
• Excess bleeding
• Blood clots
• Injury to nearby nerves
• Femoral neck fracture
• Dislocation of the hip joint
• Complications from anaesthesia.