Resurfacing Is Not For Everyone

Photo: Right hip with arm hanging down of a young person

Young and male hips should be
treated differently from old and
female ones; © SXC

In a review of over 500 surgeries performed in the U.S. using a hip resurfacing device recently approved by the Food and Drug Administration (FDA), the researchers found that the majority of serious complications occurred in women of all ages and men over the age of 55. "The ideal patients for hip resurfacing are males under the age of 55. They have the fewest, and the least serious, complications," said lead author Craig Della Valle. "Patients may be eager to take advantage of technological innovations, but for older individuals, a conventional hip replacement is generally more appropriate."

The majority of the patients suffered from severe osteoarthritis. Serious complications occurred in 32 of the 537 cases, including ten cases in which the femoral neck fractured after surgery, a problem not seen with conventional hip replacements. Such fractures require additional surgery. Nine of the fractures in the study occurred in patients who were either female or older than 55 at the time of the implant.

According to Della Valle, age and sex are probably linked to the incidence of such fractures because of bone quality and quantity. "Patients who are older or who are female tend to have softer bone," he said. "Also, men on average have larger bone structures, with a greater surface area for securing the implant."

"Hip resurfacing has certain advantages over the conventional total hip replacement," said Della Valle. "It preserves more bone because the head of the femur is retained. It enables the patient to return to high-impact sports because the metal components of the implant resist wear and tear and can withstand the forces associated with activities like running. Some studies have also shown that hip resurfacing carries a lower risk of dislocation because the size of the ball component is larger."

"But despite its benefits, risks remain," Della Valle added. "Our findings suggest that we need to be cautious. This procedure is not ideal for everyone."

MEDICA.de; Source: Rush University Medical Center