Hip Replacement Surgery | Hip Resurfacing Surgery | Hip Arthroscopy | Revision Hip Replacement | Bearing Surface Options

Hip Replacement Surgery

Hip replacement surgery has been performed for arthritis of the hip for more than 40 years. It has proven to be one of the most successful surgical procedures in terms of allowing patients to return to normal function. Over the years technology and techniques have improved, allowing us to perform hip replacement surgery on a larger number of patients with a faster recovery and better outcome.

Dr. Mayman performs hip replacements on patients with osteoarthtrits, inflammatory arthritis, osteonecrosis, post traumatic arthritis, as well as other disorders of the hip.

It is not uncommon for people to have arthritis in both of their hips. Some patients like to have both hips replaced at the same time. There are advantages and disadvantages to having bilateral hip replacement surgery.  While it is a much bigger operation with a longer time under anesthesia, more blood loss, and a more difficult rehabilitation, the benefit of bilateral hip replacement surgery is that both hips are done and the patient only has to go through one hospitalization and one rehabilitation. If you are thinking about having both hips replaced at the same time, Dr. Mayman can review all of the specific risks and benefits in relation to your specific case. You will be put through a rigorous pre-operative medical review to make sure that you are an appropriate patient for this procedure. You will then be able to make a safe and informed decision.

There are many different options for hip replacement surgery. These can be divided into surgical technique, implant choice and bearing surfaces. Dr. Mayman can discuss all of these options with you at the time of your surgical consultation.

Hip Resurfacing Surgery

Hip resurfacing is a procedure that resurfaces the hip joint in patients with arthritis of the hip. A metal liner is put into the acetabulum (hip socket), and a metal cap is put on the femoral head. This gives the joint a new surface and gets rid of pain associated with arthritis.

Hip resurfacing is a form of hip replacement surgery. There are advantages and disadvantages to hip resurfacing in comparison to standard hip replacement surgery.

Hip resurfacing uses a much shorter stem on the femur and caps the ball instead of cutting of the ball and replacing it. This maintains bone in the femur so that if another operation is needed in the future, this is potentially less complicated. Hip resurfacing puts an implant in the acetabulum (hip socket) very similar to a standard hip replacement.

The best data that we have on hip resurfacing comes from a registry of all hip replacement and resurfacing surgery performed in Australia. This registry has data on hip resurfacing that approaches 10 years. Although early studies showed that hip resurfacing had the best results in men under 55 years of age, further evaluation of the data is showing us that hip resurfacing works best in male and female patients with stronger and larger bones. Dr. Mayman will be able to determine this from your x-rays.

In my opinion hip resurfacing is a very good operation in active men under 55 years of age. Hip resurfacing is a potential option in other patients, but the risks and benefits must be reviewed on a case by case basis.

Data is convincing that the long term results of hip resurfacing are highly dependent on acetabular component position. Mechanical guides used to insert the components lead to implants being put in outside the ideal range in greater than 20% of cases. Computerized navigation during surgery can increase the accuracy of implant position and should improve long term outcome of this procedure.

Hip resurfacing is a metal on metal bearing surface. There is concern over the use of metal on metal bearing surfaces in females of child bearing age, patients with nickel sensitivity and patients with kidney disease. Dr. Mayman will be happy to review this with you in more detail during your appointment.

Hip Arthroscopy

Arthroscopic hip surgery has become a more common procedure over the past several years. Arthroscopic surgery of the hip can treat labral tears, femoracetabular impingement and numerous other problems of the hip that do not require hip replacement or resurfacing surgery.

Revision Hip Replacement

Dr. Mayman also performs revision hip replacement surgery. If you have had a hip replacement that is now painful or you have been told that you need to have all or part of your hip replacement redone, Dr. Mayman can review the specifics of your case and come up with a treatment plan appropriate for your individual case.

Bearing Surface Options

Modern day hip replacement surgery can be done with implants that have different bearing surface. The bearing surface is the articulation between the ball and the socket of the hip joint. Each of these bearing surfaces can be used with the same femoral or acetabular implants.

Bearing surface options are:

1. Polyethylene liner and cobalt chrome metal ball
2. Polyethylene liner and ceramic ball
3. Polyethylene liner and Oxynium ball
4. Ceramic liner and Ceramic ball
5. Metal liner and metal ball

All of these surfaces have advantages and disadvantages. Dr. Mayman would be happy to discuss these options with you in more detail and help determine what would be the best in your individual case.