Hip resurfacing is an old idea that has been re-engineered as an exciting new alternative to conventional total hip replacement. It has only recently been approved by the Food and Drug Administration for use in the United States.
In 2006 Dr. Huddleston was the first surgeon from Los Angeles to travel to Birmingham, England, to be trained in the Birmingham Surface Replacement (BSR) technique.
The BSR is recommended for active, young adults, ideally male patients not over 60, and females not over 50 years of age. These age limits can be raised for very active people with outstanding bone quality.
Most surgeons allow Surface Hip Replacement patients unrestricted activity after the initial healing period, including marathon running, basketball, football, racquetball and singles tennis. Some surgeons believe that a Surface Replacement is intrinsically more durable because the stresses around it are different than those around a regular hip replacement. There is no direct scientific evidence yet that that is so. A well-performed Surface Replacement should last for many years regardless of activity. And should it fail, it is an easy operation (for surgeon an patient) to convert it to a regular hip replacement. This is the main reason Surface Replacement is recommended for younger patients who wish to live a lifestyle that allows for extreme sports activity.
The patient-experience with Surface Replacement is more or less identical to total hip replacement as described above. However, the BSR is a technically much more demanding operation for the surgeon than regular hip replacement, and the complication rate is especially high for beginner BHR surgeons. It is harder to work on the socket because the intact ball of the hip is in the way. The incision must be longer than for standard hip replacement. “Edge-wear” occurs if the alignment of the socket is not perfect. This can lead to ALVAL or loosening of the socket (which can occur even if the socket placement is perfect). If the alignment of he cap is less than perfect notching of the “neck” of the hipbone can occur, setting the stage for fracture of the “neck” of the femur bone. About 2% of surface replacement patients suffer fracture of the neck within the first year after surgery (none of Dr. Huddleston’s patients so far).
DR. HUDDLESTON IS AN EXPERT ON SURFACE HIP REPLACEMENT. |
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