Joe Mitchell always assumed his chronic leg pain was due to tight muscles,
but as the pain became more intense in recent years, his physicians uncovered
the culprit: an arthritic hip. He explored treatment options, and was dismayed
to learn that he was not an immediate candidate for the main treatment for
arthritic hips: hip replacement surgery.
"Hip replacements are meant to last 10 to 20 years at the maximum. After that,
the revision surgeries are not as successful, so surgeons shy away from doing
total hip replacements on people younger than 60," said Mitchell.
Mitchell is not alone. Like the 54-year-old attorney, who always led a fit and
active lifestyle, hundreds of thousands of active baby boomers are now dealing
with worn-out joints – and the pain – at a much earlier age than their more
sedentary parents. Many, like Mitchell, are considered too young for total hip
replacements, face years of painful waiting until they "come of age," and often
balk at the prospect of limiting their activity level once the artificial joint
is in place.
But that’s beginning to change, thanks to a procedure called hip resurfacing,
which was approved by the Food and Drug Administration last May.
"Hip resurfacing is an interim solution for younger patients who face
significant pain and disability due to damaged hip joints," said Christopher
Drinkwater, M.D., assistant professor of Orthopaedics at the University of
Rochester Medical Center, who performs about two hip resurfacing procedures a
week at the Evarts Joint Center in Highland Hospital. "It allows us to fix the
problem causing the pain, but in a way that preserves enough bone so that a
patient can safely proceed to a total hip replacement down the road if it’s
Other benefits of hip resurfacing surgery include the ability to maintain impact
activities, like running or karate, and having a more natural feel of the hip
after surgery, including increased range of motion and stability.
In total hip replacement surgery, both the pelvis socket and the top of the
femur, or thigh bone, are replaced with artificial devices which allow a natural
gliding motion of the joint. A socket is implanted into the pelvic bone, while a
metal ball attached to a metal stem is driven deep into the center of the thigh
bone. It is the anchoring of the metal stem that often leaves too little solid
bone to make a follow-up replacement procedure feasible.
In hip resurfacing, the socket is still implanted into the pelvic area, but the
head of femur is only shaved to fit a metal cap, which is anchored by bone
For all of its benefits, Drinkwater cautions that hip resurfacing is still a
major surgical procedure, and takes about the same time as a total hip
"In fact, the surgery itself is more demanding on the surgeon because a more
extensive dissection is required to place the socket without removing the
femoral head. Younger patients overall tend to recover a little faster, though
initial recovery can be just as difficult," Drinkwater said.
Not everyone is a candidate for hip resurfacing, either. Men must be under 65
and women under 55, due to concerns over bone density levels. Drinkwater
requires all patients to meet minimum levels of bone density before doing the
Joe Mitchell doesn’t mind though. He had the surgery Jan. 26, 2007, and today is
doing exactly what he wants to – biking and weight lifting – but pain-free now.