OakLeaf Medical Network Healthy Viewpoints, Winter 2003
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Nathaniel Stewart, MD

HIP resurfacing

Nathaniel Stewart, MD
Orthopedic Surgery
Chippewa Valley Orthopedic & Sports Medicine
Eau Claire

Hip resurfacing, an alternative to total hip arthroplasty, has generated tremendous attention. Before this new implant procedure was available in the United States, news reports told of patients traveling across the globe to have their hip resurfaced. The internet allowed Americans to follow the progress of hip resurfacing in England and other countries where resurfacing had already been introduced. The companies that produce the implants, and the surgeons using them, provided testimonials of patients’ quick recovery and return to activities that traditional hip replacement patients were advised to avoid. Now approved for use in the United States, this new option for patients with severe hip disease is performed frequently in western Wisconsin. While not every patient is a candidate, hip resurfacing has proven to be an excellent option for highly active patients.

The traditional metal-on-plastic total hip replacement has been around for 30 years and worked well for older patients. However, it tends to fail more quickly in younger patients. Also, traditional hip replacements came with restrictions that younger, more active patients found hard to accept.

The latest evolution is to have a metal cap on the femur rubbing on a metal cup or hip resurfacing rather than hip replacement.

Dr. Stewart uses a specialized instrument to attach the implant to the femur.

The implant is inserted in a position to give stability to the hip and allow the bone to grow around it.

The large diameter head caps the end of he thigh bone (femur), conserving bone. The resurfaced hip has a more natural hip performance and may reduce the risk of dilocation.

Hip resurfacing removes very little bone; affixing smooth metal to both the hip ball and socket. The metal-on-metal articulation is more resistant to impact loading and shows very little signs of wearing out in mechanical testing. The final reconstruction is more like the original hip anatomy, and thus resistant to dislocation. The experience in practice is limited to ten years in England, and one year in the United States, but the results so far have been very encouraging.

The surgical procedure takes about an hour and a half. Most patients stay in the hospital from one to three days and use crutches or a cane for a week or two. Usually patients are back to daily activities within six weeks. I advise only limited sports activities for six months.

While not all patients with severe hip disease are candidates for resurfacing, younger patients or those with high demand activities may benefit from this procedure. An exam and x-ray are all that is required in most cases to determine if a patient is a candidate. Many other questions can be answered over the phone or with an office visit. If you or someone you know suffers from hip disease, you may be a candidate for hip resurfacing.

For more information or to schedule an appointment with
Dr. Nate Stewart, Chippewa Valley Orthopedics and Sports Medicine, Eau Claire, call 715.832.1400 or 800.322.1747, or visit Dr. Stewart’s website, www.orthostewart.com, which answers some frequently asked questions. Dr. Stewart also sees patients in Arcadia, Chippewa Falls, and Stanley.