Hip Resurfacing Still an Excellent Option by Dr. Raimund Voelker
There has been a big hype about and towards hip resurfacing and now there is
a big hype against metal-on-metal. As a specialized hip surgeon it is quite easy
to see the differences in all conclusions and recommendations.
The problems with stemmed metal-on-metal implants with big heads should
clearly be separated from discussions around resurfacing. That means those
findings of the National Joint Registry for England and Wales are not aiming
into the direction of all metal-on-metal bearings in general.
Next problem is to
find the right conclusions out of revision rates in comparison. Hip resurfacing
has a demanding operative technique and pre-selection of the patients is
necessary. The learn curve is long, some implants like the ASR and the DUROM
failed in one way or the other, many surgeons tried a couple of hip resurfacings
per year and quit later. They are all in our statistics. It is surprising that
we have almost excellent data under those circumstances, isn’t it?
Out of my experience I have 3 simple recommendations to be successful with
hip resurfacing. They count for patients and surgeons as well:
- The right patient
- the right surgeon
- the right implant
If you follow this track you are safe and most of the time better in your
overall outcomes than suggesting or performing THR. Many fear the outcomes of
ceramic-on-ceramic in the future. Maybe we face similar misleading information
about this issue soon.
Dr. Raimund Voelker
Head of hipsurgery