5 Alternatives to Hip Replacement Surgery
Severe hip arthritis can cause pain and difficulty walking. Many people who experience these debilitating symptoms due to hip arthritis will choose to have total hip replacement surgery. However, total hip replacement surgery is not without risks and concerns, and so many people wonder if there are any alternatives to hip replacement surgery. The following are 5 alternatives to hip replacement surgery:
Hip resurfacing surgery is an alternative to standard hip replacements for patients with severe arthritis. The implant is smaller and less normal bone is removed in hip resurfacing surgery. Hip resurfacing is gaining interest, especially in younger patients.
During the hip resurfacing procedure, only a small amount of bone is removed from the ball-and-socket hip joint, and a metal cap is placed on top of the ball. A metal socket is placed in the pelvis, similar to the hip replacement procedure. This hip resurfacing preserves much more normal bone than a standard hip replacement.
Hip resurfacing surgery has become much less common in recent years because of concerns about using so-called metal-on-metal joint replacements. These metal-on-metal replacements include all current hip resurfacing implants.
Metal-on-metal replacements have had some well-known recalls and problems causing both doctors and their patients to be very wary of these procedures and these implants.
Partial Hip Replacement
A partial hip replacement (hemiarthroplasty) is a commonly performed surgical procedure, but not commonly performed for hip arthritis. During this surgical procedure, only the ball of the ball-and-socket hip joint is a replacement. This is an effective treatment for certain types of hip fractures when only the ball of the hip is damaged.
The problem for people with severe hip arthritis is that the socket of this hip is also damaged, and therefore also needs to be addressed. For this reason, partial hip replacements are generally not a good option for hip arthritis surgery.
Sometimes called arthrodesis, hip fusion is a seldom-performed procedure now that hip replacement has become so successful. Hip fusion surgery eliminates all motion at the hip joint by having the bones of the femur and pelvis heal together. They are held in this position by a large metal plate and screws.
Hip fusions are usually done in young patients who are heavy labourers. The hip fusion does not wear out like hip replacements would in these patients. The hip fusion allows the patient to perform physically demanding tasks that could lead to early wear on a total hip replacement.
The problem with hip fusion is that patients will have no motion of the hip, they will walk with a limp, and may eventually need further surgery to convert to a hip replacement.
A resection arthroplasty (Girdlestone procedure) is a procedure where the bone around the hip joint is removed and the joint space is allowed to fill with scar tissue. This procedure is usually done in patients with a severe infection that cannot be controlled, or in patients whose physical condition is such that they have little chance of regular walking.
Patients who undergo a Girdlestone resection arthroplasty will likely need some device (crutches or walker) for walking.
Hip osteotomy is a procedure that is done to realign the bones of the hip joint. The osteotomy can be performed on the thigh bone (femur), the pelvis, or both. Osteotomies are usually performed on patients with an underlying problem that has led to early arthritis of the hip joint.
For example, developmental conditions such as hip dysplasia can lead to early hip arthritis. Hip dysplasia occurs in infants and leads to malaligned bones around the hip. The osteotomy helps to realign the bones and relieve the symptoms of early arthritis. These procedures must be done in carefully selected patients.
In general, hip replacement surgery is not an urgent procedure, and most often there is no harm in delaying surgery until you feel the time is right. With some exceptions, a hip replacement is an elective surgery.