Sydney Hip and Knee - Dr.Michael Solomon Dr.David Broe
Patient Info

Hip Resurfacing:   Please see the section on Hip Replacement for more comprehensive information.

Find out more about Hip Resurfacing with the following link

Hip Resurfacing

 

Introduction

Hip replacement has become necessary for your arthritic hip: this is one of the most effective operations known and should give you many years of freedom from pain.

Once you have arthritis that has not responded to conservative treatment, you may well be a candidate for a resurfacing procedure of the hip.

 

Resurfacing

A standard hip replacement replaces the acetabulum (hip socket) and the places a femoral component inside the femur (thigh bone).  Hip Resurfacing or bone conserving procedure replaces the acetabulum (hip socket) in the same way but resurfaces the femoral head. This means the femoral head has some or very little bone removed that is replaced with the metal component. This spares the femoral canal.

Resurfacing procedures may be indicated in the young active male patient. Please see the section on hip replacement for further information.

Arthritis

Arthritis is a general term covering numerous conditions where the joint surface (cartilage) wears out. The joint surface is covered by a smooth articular surface that allows pain free movement in the joint. This surface can wear out for a number of reasons, often the definite cause is not known.

When the articular cartilage wears out, the bone ends rub on one another and cause pain. There are numerous conditions that can cause arthritis and often the exact cause is never known. In general, but not always, it affects people as they get older. This form of arthritis is referred to as Osteoarthritis.

Other causes include

  • Childhood disorders e.g., dislocated hip, Perthe's disease, slipped epiphysis etc.
  • Growth abnormalities of the hip (such as a shallow socket) may lead to premature arthritis
  • Trauma (fracture)
  • Increased stress e.g., overuse, overweight, etc.
  • Avascular necrosis (loss of blood supply)
  • Infection
  • Connective tissue disorders
  • Inactive lifestyle- e.g., Obesity, as additional weight puts extra force through your joints which can lead to arthritis over a period of time
  • Inflammation e.g., Rheumatoid arthritis

In an Arthritic Hip

  • The cartilage lining is thinner than normal or completely absent. The degree of cartilage damage and inflammation varies with the type and stage of arthritis
  • The capsule of the arthritic hip is swollen
  • The joint space is narrowed and irregular in outline; this can be seen in an X-ray image
  • Bone spurs or excessive bone can also build up around the edges of the joint
  • The combinations of these factors make the arthritic hip stiff and limit activities due to pain or fatigue

Diagnosis

The diagnosis of osteoarthritis is made on history, physical examination & X-rays. There is no blood test to diagnose Osteoarthritis (wear & tear arthritis).

Risks and Complications

As with any major surgery, there are potential risks involved. The decision to proceed with the surgery is made because the advantages of surgery outweigh the potential disadvantages.

It is important that you are informed of these risks before the surgery takes place.

Complications can be medical (general) or specific to the Hip

Medical complications include those of the anesthetic and your general well being. Almost any medical condition can occur so this list is not complete. Complications include

  • Allergic reactions to medications
  • Blood loss requiring transfusion with its low risk of disease transmission Heart attacks, strokes, kidney failure, pneumonia, bladder infections
  • Complications from nerve blocks such as infection or nerve damage
  • Serious medical problems can lead to ongoing health concerns, prolonged hospitalization, or rarely death

Specific complications

Infection

Infection can occur with any operation. In the hip this can be superficial or deep. Infection rates are approximately 1%.  If infection occurs it can be treated with antibiotics but may require further surgery. Very rarely your hip may need to be removed to eradicate infection.

Blood Clots (Deep Venous Thrombosis)

These can form in the calf muscles and can travel to the lung (Pulmonary embolism). These can occasionally be serious and even life threatening. If you get calf pain or shortness of breath at any stage, you should notify your surgeon.

Dislocation

This means the hip comes out of its socket. Precautions need to be taken with your new hip forever. If a dislocation occurs it needs to be put back into place with an anesthetic. Rarely this becomes a recurrent problem needing further surgery.

Fractures (break) of the femur (thigh bone) or pelvis (hipbone)

This is also rare but can occur during or after surgery. This may prolong your recovery, or require further surgery.

Damage to Nerves or Blood Vessels

Also rare but can lead to weakness and loss of sensation in part of the leg. Damage to blood vessels may require further surgery if bleeding is ongoing.

Wound irritation

Your scar can be sensitive or have a surrounding area of numbness. This normally decreases over time and does not lead to any problems with your new joint.

Leg length inequality

It is very difficult to make the leg exactly the same length as the other one. Occasionally the leg is deliberately lengthened to make the hip stable during surgery. There are some occasions when it is simply not possible to match the leg lengths. All leg length inequalities can be treated by a simple shoe raise on the shorter side.

Leg length inequalities are less likely to occur with a resurfacing procedure.

Wear

All joints eventually wear out. The more active you are, the quicker this will occur. In general 80-90% of hip replacements survive 20- 25 years.

Failure to relieve pain

Very rare but may occur especially if some pain is coming from other areas such as the spine.

Unsightly or thickened scar

Pressure or bedsores

Limp due to muscle weakness

Discuss your concerns thoroughly with your Orthopaedic Surgeon prior to surgery.

 

Summary

Surgery is not a pleasant prospect for anyone, but for some people with arthritis, it could mean the difference between leading a normal life or putting up with a debilitating condition. Surgery can be regarded as part of your treatment plan—it may help to restore function to your damaged joints as well as relieve pain.

Our Surgeons
POW - Sydney Hip and Knee - Dr.Michael Solomon Dr.David BroePrince of Wales
(Dr. Solomon and Dr. Broe)
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Balmin Sports Physiotherapy - Sydney Hip and Knee - Dr.Michael Solomon Dr.David BroeBalmain Sports Medicine Clinic (Dr. Broe)
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UNSW Sports and Physiotherapy practice - Dr.David BroeUNSW Sports and Physiotherapy practice
(Dr. Broe)
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Sydney Hip & Knee Clinic
Sydney Orthopaedic Specialists American Academy Of Orthopaedic Surgeons Prince of Wales Balmain Sportsmed UNSW the Matter Prince of Wales Public Hospital
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