Hip resurfacing vs hip replacement

Marc Darrow, MDMarc Darrow, MD

There are a lot of options to treating your hip pain.

In patients with advanced hip arthritis, doctors may suggest a  total hip replacement (arthroplasty) or a hip resurfacing. Both of these procedures are replacing something in the hip joint. The big difference is how much is being replaced.

In hip resurfacing a prosthetic device fits over the femoral head or “ball” portion at the top of the femur (thigh bone). Damaged bone and cartilage in the hip socket are removed and replaced (as in hip with a prosthetic shell.

In hip replacement the femoral head or “ball” portion” is removed and replaced by a complete prosthetic device.

Hip resurfacing vs hip replacement

One of the main selling points for hip resurfacing is that it leaves more bone so a hip replacement can be performed later.

In our chronic pain clinic –  we see this as one hip surgery setting up another. Surgery in my opinion, should always be the last option.

Is Hip Resurfacing really a less invasive technique?

According to surgeons, hip resurfacing is more difficult to perform and requires a larger incision than typical hip replacement. This increases the risk of complications.

For an athlete or worker who’s profession is physically demanding, this can mean a lot of down time.

Does hip resurfacing keep a younger patient active?

Another main selling feature for hip resurfacing as opposed to hip replacement is that studies have shown that it allows the patient to remain more active. The problem is, it is for a limited amount of time. Hip resurfacing has a life span of 15 years. After 15 years – it is hip replacement.

So if you are a young person of 45 who loves to play tennis or other demanding sports, at age 60 those days may be gone for good as your hip resurfacing needs replacement and there is just enough bone for a total hip replacement.

What are the options?

In our clinic we try to keep the patient away from surgery because once something is removed, it cannot be restored. Such as the bone removed in hip resurfacing.

We look at the problem of the hip in another way. The reason a hip procedure is needed is because there is a bone-on-bone situation causing pain and possibly impingement of soft tissue. The reason the bone on bone situation occurred was because the connect tissue in the pelvis region, the ligaments, tendons, and cartilage have shrunk, been torn, or have become weakened through “laxity.” In other words they are stretched out.

Strengthening and restoring the connective tissue, naturally, is in my opinion, the best first option.

Prolotherapy and PRP to the hip

We look at the problem of the hip in another way. The reason a hip procedure is needed is because there is a bone-on-bone situation causing pain and possibly impingement of soft tissue. The reason the bone on bone situation occurred was because the connect tissue in the pelvis region, the ligaments, tendons, and cartilage have shrunk, been torn, or have become weakened through “laxity.” In other words they are stretched out.

Strengthened ligaments and tendons help hold the hip joint in its proper place cause less grinding and bone on bone. Restored collagen can help rebuild the cartilage between the pelvis and thigh bone – cushioning and relieving the bone on bone situattion.

Platelet Rich Plasma Therapy has become very popular. Physicians who do not do traditional Prolotherapy are now offering PRP. Unfortunately, these untrained doctors are injecting the platelets in a way that is often painful, debilitating for weeks, and can leave hematomas (collections of clotted blood) in the area injected. We believe that PRP is best delivered by a physician already experienced and well versed in Prolotherapy.

Concentrated autologous (from you) blood platelets contain large reservoirs of growth factors that have the potential to greatly accelerate the normal healing process, naturally. The use of concentrated growth factors is considered by many to be a “new frontier” of clinical therapy.