March 11, 2008
Both total hip replacement or total hip arthroplasty (THA), and hip
resurfacing procedures continue to spark a lively ongoing discussion among
orthopedic surgeons. Some are calling hip resurfacing a more effective
alternative, while others are saying complications associated with
resurfacing far outweigh its effectiveness.
Total hip replacement involves an orthopedic surgeon removing the head (or
ball) and neck of the femur (thigh bone) and replacing them with a metal
implant. The resurfacing procedure reshapes the head of the thigh bone and
covers it sparing part of the bone with a metal and plastic implant.
"Hip resurfacing is not new to orthopedics it has been around for more than
10 years now," said William Maloney, MD, professor of surgery and chair of
the Department of Orthopedic Surgery at Stanford, University. "We are now
starting to acquire experience and measurable data associated with the
procedure and its outcomes. One reason for this discussion is because
orthopedic surgeons are dealing with more direct to consumer advertising
today when it comes to resurfacing. Patients are coming into our offices and
asking for the procedure without really understanding what is involved or
even if they are a suitable candidate."
Those who perform hip resurfacing procedures say:
•It is a less invasive surgery with a shorter hospital stay and recovery
•Patients experience a better range of motion after surgery
•Patients experience a longer implant life
Those who perform total hip replacement say:
•It is no more invasive than resurfacing
•Healing time is much the same as for resurfacing patients
•More of the patient population stands to benefit from total hip replacement
Maloney moderated a frank and fact filled discussion on the merits of both
procedures at a media briefing entitled: "Getting Hip to Hip Surgery:
Resurfacing and Replacement," last week at the 75th Annual Meeting of the
American Academy of Orthopedic Surgeons (AAOS).
The panel of presenters included: Paul Beaule, MD, Robert Trousdale, MD,
Paul Lachiewicz, MD, and Tom Schmalzried, MD.