Treatment Guide Hip Pain - Cleveland Clinic

Hip resurfacing
For some active younger patients with arthritis or osteonecrosis
of the hip, “hip resurfacing” is an alternative to total hip replace-
ment that can stabilize the hip and alleviate pain.
Approved by the U.S. FDA in 2006, hip resurfacing involves
shaving away a few millimeters of bone in the hip joint, then
capping the joint surface with a metal implant. Hip resurfacing
preserves more bone than hip replacement and allows for easy
hip replacement down the road if needed.
Recovery – Patients can expect to be on crutches for six weeks
afterward. Physical therapy begins in the hospital and most
patients learn all the exercises they need to do before they go
home. In about one year, resurfacing patients will be able to
resume their routine exercise habits.
Benefits – The advantages include keeping more of your own
bone, which feels more natural. The approach also reduces the
risk of inaccurate leg length and dislocation. Patients who have
hip resurfacing are also still candidates for a total hip replace-
ment, if needed, down the road.
Who is a candidate? – Hip resurfacing is not for everyone.
Candidates are active people under age 60 with strong bone
health, good renal function and no allergies to nickel or any
other metal. Resurfacing procedures are not appropriate for
patients with osteoporosis or kidney disorders or for women of
child-bearing age.
TREATMENT GUIDE | HIP PAIN | CLEVELAND CLINIC
Risks – There are two main risks involved in hip resurfacing.
In about one percent of cases, patients with weak bones who
undergo the procedure subsequently suffer fractures of the
femur. If this occurs, it usually happens within six months of
a resurfacing operation, in which case the patient will usually
have to move on to total joint replacement. But the good news
is that the socket doesn’t have to be changed.
ORTHOPAEDIC AND RHEUMATOLOGIC INSTITUTE
The other potential disadvantage is related to
the metals – cobalt and chromium – that com-
prise the components of a resurfaced joint.
Ions of these metals will inevitably leak into a
patient’s bloodstream after resurfacing. In oth-
er non-joint replacement situations, high levels
of these metals have been associated with
cancer, heart disease and kidney dysfunction.
However, in patients with metal-on-metal
joint implants, no increased risk of cancer has
been seen, and in fact, patients tend to live
longer with hip resurfacing. To minimize the
ion levels, hip resurfacing patients must have
well-functioning kidneys that are capable of
adequately cleansing the blood.
Durability – Metal-on-metal hip resurfacing
has only been performed for 15 years, so
longer-term data is not available. However,
we know that more than 95 percent are still
functioning at 10 years, and in young, active
patients the results are as good as or better
than total hip replacement.
Same-day appointments are available.
866.275.7496 | clevelandclinic.org/ortho