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Hip Resurfacing Arthroplasty

Dr. Mont is Director, Center for Joint Preservation and Reconstruction, Rubin Institute for Advanced Orthopaedics, Sinai Hospital of Baltimore, Baltimore, MD. Dr. Ragland is Clinical Research Fellow, Center for Joint Preservation and Reconstruction, Rubin Institute for Advanced Orthopaedics, Sinai Hospital of Baltimore. Dr. Etienne is Attending Surgeon, Center for Joint Preservation and Reconstruction, Rubin Institute for Advanced Orthopaedics, Sinai Hospital of Baltimore. Dr. Seyler is Clinical Research Fellow, Center for Joint Preservation and Reconstruction, Rubin Institute for Advanced Orthopaedics, Sinai Hospital of Baltimore. Dr. Schmalzried is Associate Director, Joint Replacement Institute, Los Angeles, CA.

Dr. Mont and Dr. Etienne serve as consultants to or are employees of Wright Medical Technology. Dr. Schmalzried or the department with which he is affiliated has received research or institutional support from DePuy and Wright Medical Technology. Dr. Schmalzried or the department with which he is affiliated serves as a consultant to or is an employee of DePuy. None of the following authors or the departments with which they are affiliated has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Ragland and Dr. Seyler.

Reprint requests: Dr. Mont, Rubin Institute of Advanced Orthopaedics, Center for Joint Preservation and Reconstruction, Sinai Hospital of Baltimore, 2401 West Belvedere Avenue, Baltimore, MD 21215.

Hip resurfacing arthroplasty is a type of hip replacement that involves capping the femoral head and preserving bone of the proximal femur. Metal-on-metal surface replacements have been manufactured since the early 1990s. Recent studies indicate excellent clinical results with low failure rates at 1- to 5-year follow-up. Although these early results are encouraging, resurfacing devices must be used with caution because less is known about their long-term safety and efficacy. The best candidates for resurfacing are patients younger than age 60 years with good bone stock. The surgical approach is similar to that for standard total hip replacements, but with slightly more dissection because the femoral head must be preserved and displaced to visualize the acetabulum. To reduce complications, resurfacing arthroplasty should be performed by surgeons who have received training specifically in this technique.

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