Orthopedics: Hip Resurfacing
Patients with chronic hip pain now have another option besides hip replacement surgery to alleviate their suffering. Randall Jennings, MD, an Orthopedic Surgeon at Fort HealthCare Orthopaedic Associates, performs the innovative Birmingham Hip Resurfacing surgery, a bone conserving alternative to total hip replacement surgery. He is one of only 500 doctors (less than two percent of all active orthopedic surgeons) across the nation trained to use this new technology.
Traditional Hip Replacement Surgery
The hip joint is often described as a “ball and socket," and it is this ball and socket that is the focus of hip replacement surgery. During traditional total hip replacement surgery, the hip is dislocated to remove damaged cartilage and bone. The top or head of the femur (the largest of the bones in the leg) and part of its neck are removed with a bone saw. A metal stem is placed down the center of the femur and a metal head is placed on the stem. This becomes the new ball. The socket is replaced by a metal shell around a plastic cup. Bone cement is sometimes used to secure the stem.
How is the Birmingham Hip Resurfacing procedure different?
The Birmingham Hip Resurfacing procedure is a bone-conserving technique that uses a two-part all-metal implant. Most importantly, the head of the femur and its’ neck are not removed as occurs in the traditional total hip replacement surgery. Instead, the Birmingham Hip Resurfacing surgery uses specialized tools to resurface the existing bone. The socket is shaped to accept a new cup, and an all-metal (not plastic) cup with a porous surface is inserted. The head of the femur is prepared to receive the new cup. The procedure involves shaving just a few millimeters of bone around the femoral head and a new metal cap is applied. The cap is made of cobalt chrome, a very durable material.
Worldwide, over 80,000 Birmingham Hip Resurfacings have been performed with a ten-year survival rate of over 98 percent. Several facilities offer hip resurfacing, but Fort HealthCare offers the Birmingham Hip Resurfacing System, which is the only system approved by the Food and Drug Administration.
What are the benefits of the Birmingham Hip Resurfacing procedure?
While all forms of hip replacements allow improved mobility, hip resurfacing more closely mimics the normal hip. After having a total hip replacement, it is difficult to return to active sports, as only light activity is recommended. In contrast, patients have run marathons and continued high levels of activity after hip resurfacing.
In addition to bone conservation, another significant benefit of the new procedure is faster recovery time. Most patients are able to start walking with the use of crutches just two days after the procedure. Patients who follow the recommended rehabilitation process can expect to ride a bike three to six months after surgery, and start running after a year. The risk of hip dislocation is considerably less than with a total hip replacement. The end result is a quicker return to a normal, active lifestyle.
Jennings states, “Patients have been extremely interested and receptive to this procedure because of the bone conserving aspect of hip resurfacing. However, an unexpected benefit has been the extremely rapid recovery time after hip resurfacing. My latest patient who underwent hip resurfacing saw me 16 days post-operatively and was walking without assistive devices (crutches and walker) and had no limp or pain. While I can’t promise that for all patients, I have not seen such a rapid recovery after 11 years of performing total hip replacements.”
Are their risks?
The risks of hip resurfacing are similar to those of traditional hip replacement, which can include infections and bone fractures. This bone-conserving procedure helps to reduce the risks of dislocation, and inaccurate leg length. A study on the effectiveness of this new procedure found that 99.5 percent of patients felt they were “pleased” or “extremely pleased” with the Birmingham Hip Resurfacing surgery.
Who is a good candidate?
Birmingham Hip Resurfacing is recommended for patients under the age of 65 who have good bone quality and want to retain an active lifestyle. Women in their child-bearing years, elderly and inactive men and women, patients suffering from chronic forms of arthritis and osteoporosis, and patients with leg-length discrepancies are less likely to be candidates for hip resurfacing. Conversely, total hip replacements are primarily intended for patients in their late 60’s and early 70’s.
Jennings earned his medical degree from Emory University School of Medicine, in Atlanta, GA. He completed his orthopedic surgery residency at Tulane University Medical Center in New Orleans, LA, where he trained under his residency program director, Robert Barrack, MD. Barrack performed the first Birmingham Hip Resurfacing in the United States. He completed an orthopedic sports medicine fellowship at Methodist Sports Medicine Center, Indianapolis, IN, where he provided orthopedic and sports medicine consutation with the Indianapolis Colts and Purdue University. He also served in the U.S. Air Force as Chief of Sports Medicine at the U.S. Air Force Academy. Jennings, in summing up his feelings toward his profession said, “I love my field because I enable people to get active again.”
Fort HealthCare Orthopaedic Associates provides services in the following locations: Fort Atkinson, Edgerton, Whitewater, Lake Mills, and Stoughton. For appointment information please call the Fort Atkinson Clinic at (920) 563-7888. Additional information about Birmingham Hip Resurfacing is available online at www.birminghamhipresurfacing.com.