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Birmingham Hip Resurfacing(BHR) Surgery

Hip Resurfacing surgery in India

Birmingham Hip Resurfacing(BHR) Surgery

Package Cost : $7,500

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Hip resurfacing surgery is a bone conserving revolutionary alternative to traditional hip replacement surgery for few selected patients particularly young and active with strong bones, who are suffering from hip arthritis to an extent that the patient is unable to carry out day to day activities and none of the non surgical modalities prove beneficial. 

Q1 What is a hip joint?

 

A1 Hip joint is a type of ball and socket joint. Under normal conditions, the contact surfaces of the bones, in this case, head of the femur and the socket in the pelvic bone(acetabulum) are covered with smooth cartilage that ensures smooth gliding of bones against each other.

 

Q2 What is the difference between Hip resurfacing surgery and Total hip replacement surgery?

 

A2 Birmingham Hip resurfacing surgery(BHR) is bone conserving alternative to traditional Total Hip replacement surgery.

Total hip replacement surgery involves the removal and replacement of the whole hip joint with metal,plastic or ceramic parts. THR calls for the removal of the upper portion of the femur to accommodate the stem portion of the implant. Hip resurfacing does not remove the head of the thigh bone, the contact(articulating) surface of the head(Ball) of the Femur is trimmed and shaped and eventually a smooth metal cap is closely fitted over it. The damaged bone and cartilage in the the socket (acetabulum) in the hip bone are removed and metal shell is positioned well inside the socket in both Total hip replacement arthroplasty and Hip resurfacing arthroplasty. 

It is also referred to as Metal-on-Metal implant. These implants are more bone conserving devices and also preserve the natural geometry.

Hip resurfacing is invariably recommended for young and active patients with strong bones as it offers greater stability, reduced risk of complications such as dislocation of the hip joint and unequal length of the lower limb and easy revision surgery,if need be. 

 

Q3 What is done during hip resurfacing surgery?

 

A3 During Hip resurfacing surgery, an incision is made in the thigh to access the arthritic hip joint. The head of the femur is positioned out of the socket, trimmed, shaped and eventually covered with a smooth metal cap.

This mushroom shaped hollow metal cap is made up of Cobalt chrome and snugs the head of the femur well.

The damaged cartilage lining the socket of the hip bone, where the head of the femur resides,is removed and replaced with metal cup.

Once the metal cup is in place, the femoral head now covered with smooth metal cap is replaced back into original position and the incision is closed.

Here, the head of the thigh bone is intact unlike that in conventional Total hip replacement surgery.

Successful outcome of the surgery depends upon the surgeon's level of experience with the resurfacing technique, careful selection of the implant and its proper positioning.

 

Q4 What type of anesthesia is required in Hip resurfacing surgery?

 

A4 Hip resurfacng surgery can be carried out under General anesthesia(Patient is put to sleep) or Spinal anesthesia(Patient is awake while the lower part of the body down the waist is numb).

 

Q5 What is the duration of the Hip resurfacing surgery?

 

A5 The Hip resurfacing surgery typically lasts between 1.5 to 3 hrs.

 

Q6 Who is the right candidate for Hip resurfacing surgery?

 

A6  Hip resurfacing surgery is generally recommended for young(<60yrs of age) and active patients with strong bones and large body built, often but not invariably males, who are suffering from advanced arthritis.

Older patients,people with small body built, with weaker and damaged bones and females are not considered good candidates for hip resurfacing because of the fear of developing complications like Femur neck fracture.

However, your orthopedic surgeon will determine the best treatment option for you after your thorough clinical examination and comprehensive evaluation of your medical reports.

 

Q7 What are the advantages of Hip resurfacing surgery?

 

A7 Although a great deal of research is being carried out on this subject. Diferent orthopedic surgeons hold different perspectives regarding the advantages of Hip resurfacing surgery over conventional Total hip replacement surgery. Your specialist will determine the best treatment protocol for you after weighing the pros and cons of each procedure. 

Apparently, the advantages can be broadly listed as follows:

  • Bone conserving surgery.

  • Hip resurfacing surgery can be revised easily, if need be.-Hip resurfacing at a younger age ensures smooth revision surgery later since it does not involve removal of the upper portion of the femur. Later, when revision would be required, the femur bone will be intact to accommodate the metal stem(Total hip replacement implant). However, if Total hip replacement arthroplasty requires revision surgery, the metal stem already in would have to be removed and replaced by new large diameter stem and this process is accompanied by more bone loss.
  • Reduced risk of hip dislocation-The large size of the metal cup and cap are comparable to the patient's original ball and socket and make it less vulnerable to dislocation. However, there are other factors as well that affect the risk of dislocation such as the type of surgical approach and the type and size of the implant.
  • Closer to normal gait.
  • Greater range of motion of the hip joint post surgery.
  • Hip surfacing allows young and active people to persue the activities that they used to enjoy prior to the surgery, an advantage over conventional Hip arthroplasty- A more active lifestyle.
  • With Hip resurfacing, since the femoral neck or upper portion of the femur is retained, it results in retention of its natural mechanical attributes under stress. It also ensures less interference in the processes that are going on in the bone that is alive.

In nutshell, the quality of life of the patient is significantly improved and patient is satisfied after Hip resurfacting arthroplasty.

 

Q8 What are the disadvantages of Hip resurfacing surgery?

 

A8 The following are the disadvantages that may be associated with the hip resurfacing surgery:

  • Femoral neck fracture- a significantly small percentage of patients who have undergone hip resurfacing surgery may experience femoral neck fracture which is not the case in THR as that involves the removal of the femoral neck and its replacement with a metal stem. However, the fracture around the implants can still occur even in THR.
  • Metal ion menace- Hip resurfacing involves the movement of the metal ball against the metal socket that may result in the formation of tiny metal particles over time, also referred to as metal ions. Some patient may respond to production of metal ions by developing allergy or sensitivity that may manifest as pain and swelling. This may be the potential risk in THR also if that also involves metal on metal implant. 
  • Hip resurfacing surgery is sophisticated and requires more skills.

Q9 When do I need hip surgery in case of arthritis?

 

A9 If you have an advanced hip arthritis to an extent where normal daily activities seem impossible, your quality of life is severly compromised and you have exhausted all non surgical treatment modalities without any benefit, then your specialist may consider surgery as a viable treatment option for you.

 

Q10 How long would the hospital stay be for Hip resurfacing surgery?

 

A10 Generally, the hospital stay would be around 4 to 5 days after surgery.

 

Q11 When can I resume my daily activities after Hip resurfacing surgery?

 

A11. You will probably resume your daily activities by 6 weeks post surgery.

 

Q12 What are the contraindications for Hip resurfacing surgery?

 

A12 Under the following conditions, hip resurfacing surgery is absolutely advised against:

  • ​​​​​Advanced age

  • Postmenopausal women with Osteoporosis

  • Compromised renal function

  • Metal hypersensitivity

​Other conditions such as femoral head or neck cysts, hip dysplasia of severe intensity or deficient bone stock of femoral head or neck and small acetabulum.

 

Q13 What do you mean by revision surgery?

 

A13 The components or implants used in both conventional Total hip replacement surgery and Hip resurfacing surgery are after all mechanical parts. They can wear out or loosen over time, although that duration is around 10 to 20 yrs generally, post surgery. Under such scenario, an additional surgery is required, also referred to as Revision surgery.

 

Q14 What are the complications of Hip resurfacing surgery?

 

A14 Though rare, the most common complications of Hip resurfacing are:

  • Blood clot formation in the leg veins

  • Infection

  • Injury to nerve or vessels

  • Femoral neck fracture

  • Dislocation

  • Anesthesia related perils.

Birmingham Hip resurfacing surgery in India:

 

  • Most affordable cost coupled with best quality.

  • Good success rate

  • Zero waiting time.

  • Best hospitals with state of the art infrastructure and most advanced technology in place.

  • Globally trained,highly skilled and experienced orthopedic surgeons with good track record.

  • Great ambience

  • Compassionate staff to look after

  • Hospitals accredited with international organizations such as JCI(Joint commission International) for quality standards.

  • Language no barrier. English speaking people and if required, translators are available for your convenience

  • Most economical accommodation available at a walking distance from the hospital. Wide range of options starting from guest house, service apartments to five star hotels, best suited to your budget and choice.

  • FDA approved high quality implants

Dr Kaushal Malhan

MBBS,MS(Ortho),FRCS(Orth) U.K, Dip. Sports Medicine, UK

Consultant,Knee and Hip surgeon

Fortis Hospital, Mulund,Mumbai

 

Dr S.K.S Marya

MBBS, MS(Ortho), DNB, MCh(Ortho),FRCS,FICS

Chairman-Medanta Bone and Joint Institute

Medanta The medicity,Gurgaon,Delhi-NCR

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