Hip Resurfacing is Viable Alternative to Hip Replacement
Patients who had hip resurfacing surgery, such as the Birmingham Hip
Resurfacing technique, reported a better quality of life, less pain and greater
satisfaction a year after surgery than those who had a total hip replacement.
PRLog (Press Release) - Jul 31, 2009 - Oceanside, NY – Patients who had hip
resurfacing surgery, such as the Birmingham Hip Resurfacing technique, reported
a better quality of life, less pain and greater satisfaction a year after
surgery than those who had a total hip replacement, according to a study
presented at the American Academy of Orthopedic Surgeons (AAOS) 2009 Annual
Meeting.
The study was based on data on the outcomes of 214 total hip replacement
patients and 132 hip resurfacing patients that was recorded in a joint registry
maintained at a single surgeon’s practice from 2003-2006. Orthopedic surgeon Dr.
Elizabeth Anne Lingard of Freeman Hospital in Newcastle Upon Tyne, England, was
the study’s lead researcher.
Each patient enrolled in the study completed a questionnaire preoperatively and
one year after surgery. The questionnaire included the Western Ontario and
MacMaster Universities Osteoarthritis Index (referred to as WOMAC, it is a
24-item questionnaire that is completed by the patient and focuses on joint
pain, stiffness and loss of function related to osteoarthritis of the knee and
hip) and the SF-36, a self-report questionnaire completed by the patient that
measures health-related quality of life (and generates 8 subscales: physical
functioning, role limitations due to physical problems, bodily pain, general
health perceptions, vitality, social functioning, role-limitations due to
emotional problems, and mental health; and 2 summary scores: physical component
and mental component). The patients also completed a questionnaire regarding
satisfaction with their procedures and outcomes one year after surgery.
The study showed that one year after surgery both groups of patients experienced
significant improvements in WOMAC and SF-36. Hip-resurfacing patients, however,
posted significantly higher WOMAC scores for decreased pain symptoms. When asked
about patient satisfaction with the surgery, a greater number of hip-resurfacing
patients said they were satisfied with their ability to perform functional
activities after surgery.
"The (Birmingham) hip resurfacing technique allows me to preserve more of the
patient’s natural bone structures and stability," said Bradley Gerber, MD, Chief
of Joint Replacement Surgery at South Nassau Communities Hospital. "I see hip
resurfacing as the ideal solution for many of my younger, active patients who
suffer from hip pain. As my patients are getting younger and younger, and are
staying physically active much later in life, I've needed an alternative to
total hip replacement that accommodates their age and lifestyle. Hip resurfacing
is that alternative."
Dr. Gerber was among the first surgeons in the U.S. to perform the Birmingham
Hip Resurfacing (BHR) technique. Rather than replacing the entire hip joint, as
in a total hip replacement, hip resurfacing simply shaves off the damaged
cartilage and bone and a metal cap is placed onto the head of the leg bone
(femur).
Total hip replacement involves the removal of the entire femoral head and neck,
replacing it with a metal ball, while the BHR leaves the head and neck
untouched. It is the neck length and angle that determines the natural length of
a patient’s leg after surgery. Since it is not removed and replaced with an
artificial device during the resurfacing procedure, there is a greater
likelihood of maintaining accurate leg length.
In addition, traditional hip replacements use a plastic socket compared to the
BHR implant (which is a metal socket). A plastic socket wears down over time,
and may need to be replaced surgically. In fact, it is a leading cause of
follow-up surgeries.
The BHR is intended for patients suffering from hip pain due to osteoarthritis,
hip dysplasia (a congenital disease that, in its more severe form, can
eventually cause crippling damage and painful arthritis of the joints) or
avascular necrosis (a disease resulting from the temporary or permanent loss of
the blood supply to the bones, often leading to collapse of the joint surface),
and for whom total hip replacement may not be appropriate due to an increased
level of physical activity. For these reasons, Dr. Gerber feels the BHR is ideal
for patients under age 60 who live non-sedentary lifestyles.
While the BHR implant closely matches the size of a patient’s natural femoral
head (hip ball), it is substantially larger than the femoral head of a
traditional total hip replacement implant. This increased size translates to
greater stability in the new joint, and it decreases the risk of dislocation of
the implant after surgery, which is a leading cause of implant failure after
total hip replacement.
In addition to the BHR, orthopedic surgeons at South Nassau’s Long Island Joint
Replacement Institute specialize in custom-fitted total joint replacement as
well as minimally invasive joint replacement surgery, such as the Uni-Knee®
partial knee replacement and Image-Guided Knee Replacement technique. Minimally
invasive joint replacement reduces trauma to surrounding tissue, blood loss
during surgery, post-operative pain, and recovery time, leading to a speedier
rehabilitation and return to daily activities. According to Dr. Gerber, the
average length of stay of patients treated by the institute is less than 3 days,
which is well below the national average.
The Joint Replacement Institute combines image-guided medical technology with
minimally invasive knee replacement instrumentation. Image-guided surgical
technology is used to determine the precise alignment of the replacement parts;
improves the surgeon’s view of and feel for the surgical field and reduces the
size of the incisions to perform a replacement.
Other procedures offered by the Institute’s physicians include reconstruction of
foot and ankle injuries, pediatric orthopedics, hand and upper extremities, and
meniscus cartilage transplantation and Carticel Therapy to correct recurring
knee cartilage injuries.
For more information about the Long Island Joint Replacement Institute or to
schedule a consultation, call 1-877-SouthNassau.
www.southnassau.org.
