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Hip Resurfacing

Hip resurfacing is a type of hip replacement surgery where implants are used to replace small sections of the hip joint, such as the bone or tissue, rather than the entire joint.

Also known as: hip resurfacing arthroplasty

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Everything you need to know

Hip resurfacing is a type of hip replacement surgery where implants are used to replace small sections of the hip joint, such as the bone or tissue, rather than the entire joint. Hip resurfacing may be recommended if you have osteoarthritis in your hips and are a male under 65 with healthy bones. Hip resurfacing is rarely done in females as the outcomes are not as successful. Osteoarthritis occurs naturally with age and happens when the padding in your joints (cartilage) wears away, leading the bones to rub against each other, which causes pain and limits movement. Hip resurfacing involves trimming away the damaged bone and cartilage in your hip joint, leaving most of the joint intact. Smooth implants are then placed at the top of the thighbone and within the hip socket, allowing for pain-free movement.

Your doctor will always try non-surgical treatments first such as activity modification and lifestyle changes, weight-loss if appropriate, pain-relief, physiotherapy and hip injections. However, if the problem gets to a point where you’re finding walking difficult, are experiencing a general reduction in mobility, pain at night or difficulty putting on shoes and socks – and non-operative options are no longer working, then your doctor may recommend hip resurfacing. If possible, it’s best to keep as much of your body’s natural tissues in place, which is why hip resurfacing is a good option. However, it isn’t suitable for everyone. For example if you are over 65, a hip replacement would be a better solution. This is because this age group has weaker bones, which may not withstand resurfacing. Females also have less successful outcomes from resurfacing and so this procedure is rarely done in women.

Before Surgery

At your initial appointment, your doctor will thoroughly discuss the surgical options with you, as well as the risks and benefits so you can make an informed decision.

If you decide to go ahead with surgery, we will help you prepare, but you should also try to eat healthily in the run up and stop smoking if you can.

Before your surgery, you will also need to come into hospital for a pre-assessment, where we can check your fitness for surgery. This is a standard check and includes blood tests, heart and lung function tests as well as an MRSA test. We will also give you some specific antibacterial soap and lotions to use in the run up to the procedure, which will help reduce your risk of contracting MRSA.

If you take any blood thinners—for example, warfarin or aspirin, tell your doctor straight away, as you may need to stop taking these or modify your intake from a week before surgery. Your doctor will give you specific instructions if this is the case. You should also tell your doctor if you take nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen.

From midnight on the day of your surgery, do not eat or drink anything. This includes water, chewing gum and boiled sweets. Brush your teeth with toothpaste only on the morning of surgery.

On surgery day, it’s a good idea to wear loose, comfortable clothing and bring a small bag with things you might need during your stay. Items to remember include a toothbrush and toothpaste, your phone and a charger, a book, any prescription medications and a change of clothes. Your doctor will let you know if you can take any medications with a sip of water before surgery or if you should wait until after.

Once you have arrived and are settled in your room, a nurse will monitor your vital signs (such as body temperature and blood pressure) and run through your medical history, medications and emergency contacts.

Your doctor will then once again run you through the procedure and ask you to sign a consent form for surgery.

During surgery

Hip resurfacing is usually done with spinal anaesthesia and sedation. Unlike general anaesthesia you will be breathing on your own, so will not need a breathing tube. Spinal anaesthesia is preferable as your recovery post-surgery will be faster and side effects such as nausea and sickness will be reduced.

You will have an intravenous (IV) line fitted into a vein. This is usually on an arm or hand. Through this, your surgical team can quickly give you medications and fluids. The surgical team will also place monitors on you so you can stay safe throughout the surgery.

The doctor will then make a small incision at the top of the thigh and will trim away small amounts of damaged bone and cartilage. These will be replaced with the implants, which will be held in place using bone cement. To finish, the incision will be closed with stitches.

After Surgery

Once we’re happy you’re doing well, we will take you to your private room where you can start your recovery. You will usually be able to walk the same day or the day after; some patients will need a crutch or sticks for support.

During your stay, our nursing team will make regular checks to make sure your recovery is going to plan. You will also be visited by a physiotherapist and an occupational therapy if needed. Before you are discharged, you will need to be cleared by the physiotherapist and nursing team, have a check x-ray and blood tests. Your surgeon will also visit you and make sure you are happy. You will be able to go home after 24- 48 hours. It will take approximately two weeks for your wound to heal, and you should see your doctor at this point for a post-surgery check, where your stitches will be removed.

In the weeks following an operation, patients have a slightly higher risk of a blood clot, so will need to avoid flying. You should wait six weeks before taking a short haul flight (under six hours) and 12 weeks before taking a long-haul flight. You should also expect to be off work for around six weeks, but depending on your recovery, this could take a little longer – everyone is different.

During this time, you will need to build up your strength by walking and keep your hip mobilised with gentle movement. Consistently and regularly doing your physiotherapy rehab exercises is essential to your recovery. We have an excellent therapies team at St John & St Elizabeth Hospital that can support you throughout your recovery.

The overall period of rehab can take up to one year, but most patients do very well and can go back to work after around 6-8 weeks.

How to pay for your treatment

If you’re… paying for yourself

Did you know you don’t need private medical insurance to come to St John & St Elizabeth Hospital? As a self-pay patient, you can access safe, outstanding quality health care at times to suit you.

For scans and tests, as well as to see most consultants, you’ll still need to be referred by a medical professional like your GP, but as a self-pay patient, the process is more straightforward. You won’t need authorisation from an insurance provider, and you’ll have greater choice of consultant and appointment times.

If you’re… insured

St John & St Elizabeth Hospital is approved by all major medical insurance companies. If you have a personal private health insurance policy, or your company provide it for you, you can use it to pay for your care from your initial consultation through to treatment, surgery and aftercare such as physiotherapy. Not all private health insurance plans cover the same things. It’s very important to check exactly what you are covered for with your insurance provider.

01

Appointment

You will have an initial consultation with a lower limb orthopaedic surgeon.

02

Treatment plan

During this appointment, you’ll go through your medical history, the risk and benefits of surgery and what to expect from recovery. Together, you will decide whether hip resurfacing is the best option for you.

03

Pre-op assessment

If you decide to go ahead with surgery, you will need to come in for a pre-assessment, which is a standard ‘fitness for surgery’ check.

04

Surgery

The surgery itself should take a couple of hours. You will be able to walk the same day or the day after and can go home after 24- 48 hours.

05

Aftercare

You will need to keep your wound clean and dry, take pain relief and have physiotherapy consistently. You will not be able to fly short-haul for six weeks or long-haul for 12 weeks. We have an excellent therapies team at our hospital that can support you throughout your recovery.

06

Follow-Up

You will have a follow-up appointment with your doctor at two weeks, where stitches will be removed. You should also have follow-ups at 6 weeks, 12 weeks, 6 months and 1 year.

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