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Hip Resurfacing, sometimes called Birmingham Hip Replacement is an surgical treatment options for patients with hip arthritis.
In hip resurfacing, the arthritic femoral head (i.e the ball part of the hip joint) is not removed. Instead, the femoral head is “capped” or resurfaced with a thin artificial surface prosthesis. The socket component of the hip joint is treated in the same manner as in a total joint replacement, with an artificial cup placed into the socket (acetabulum) of the hip joint.
There potential attraction with hip resurfacing is that less bone is removed than in a hip replacement. However, there are several drawbacks as well.
The most significant concern is that in order to have a material thin enough to use as the cap on the femur, both sides of the prosthesis (i.e both the ball covering and socked) are currently made out of metal.
The hip joint will consequently then have two metal surfaces which rub against one another when the joint moves. This is usually not an issue but in some patients, metal particles released from a metal-on-metal joint replacement can cause serious tissue reaction and early loosening of the prosthesis.
Although the incidence of metal-on-metal problems is small, surgeon and patient concern about the small potential for adverse reactions has led to a decline in the the number of metal-on-metal hip resurfacing procedures performed around the world. This trend may change in the future when orthopaedic implant companies manage to develop a hip resurfacing prosthesis which is not made out of metal.
Mr Freedman generally does not recommend metal-on-metal resurfacing but will instead usually suggest a “short stem” ceramic–on-ceramic total hip replacement instead. Use of hard-bearing ceramic hip implants with a short stem achieves the best of both worlds in that it allows a hard-bearing articulation with negligible wear rate, while avoiding the potential issues associated with metal-on-metal. Using a special short stem allows for less bone removal and easier later revision if necessary (unlikely).
Hip Resurfacing was originally developed by a surgeon in Birmingham, UK. The operation is consequently often attributed to him as is called a “Birmingham Hip Replacement”.
Mr Freedman does offer hip resurfacing for a select group of patients who meet appropriate selection criteria, but is offering this operation less frequently since the emergency of ceramic-ceramic anterior hip replacement. Anterior ceramic hip replacement offers a less invasive operation with excellent longevity, while avoiding potential risks associated with metal-on-metal implants.