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Hip Resurfacing

An Alternative to Hip Replacement

Hip resurfacing is an alternative to total hip replacement for some patients with degenerative hip disease and abnormalities such as osteoarthritis, post-traumatic arthritis, dysplasia or avascular necrosis. Hip resurfacing often conserves more natural bone than a traditional hip replacement, enabling individuals to return to high-demand occupations and recreational activities.

Washington University orthopedic surgeons at Barnes-Jewish Hospital are specially trained in hip resurfacing techniques. More than 250 hip resurfacing procedures have been performed by Washington University surgeons, making it the one of the most experienced hip resurfacing programs in the nation.

Hip Resurfacing vs. Hip Replacement

During traditional hip replacement surgery, both the head and neck of the femur (thighbone) are removed and replaced with metal or plastic implants. In hip resurfacing, the head of the femur is resurfaced with a metal hip “joint” and the rest of the thighbone is left intact.

Some implants used in traditional hip replacement surgery are smaller than the bone which they replace. Hip resurfacing was conceived as a way to more closely match the size of the head of the femur bone while potentially increasing stability and decreasing opportunity for dislocation, one of the most common complications of total hip replacement.

Potential Advantages of Hip Resurfacing

  • Bone preservation (less bone removal)
  • Increased stability
  • Decreased risk of hip dislocation
  • Low wear rate with expected long implant lifetime
  • Few, if any, physical limitations on patients following surgery
  • Less bone loss over time (stress shielding)

Hip resurfacing can be ideal for physically active patients under the age of 60 who hope to remain active. “We often see patients in their 40s and 50s who already are experiencing severe osteoarthritis,” says Robert Barrack, MD, Washington University orthopedic surgeon at Barnes-Jewish. Dr. Barrack and his partners, John C. Clohisy, MD, and Ryan Nunley, MD, lead the innovative patient care team for the joint preservation and replacement service at Barnes-Jewish, which works to provide the best treatment option and service for each patient.

While innovative, it should be noted that hip resurfacing has certain advantages and disadvantages and is not for everyone. Patients with osteoporosis, limb shortening more than one-half inch, severe hip deformity and prior hip surgery are not good candidates for hip resurfacing.

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