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Hip Resurfacing 

Introduction
Hip resurfacing is a procedure that is used to relieve pain and restore function for people with arthritis or other hip conditions.  Unlike traditional total hip replacement, hip resurfacing does not remove the bones in the joint, but instead resurfaces the bone with smooth metal.  Hip resurfacing conserves bone and is a less-invasive procedure than total hip replacement.  Younger active people are the best candidates for hip resurfacing.  Overall, hip resurfacing is a successful procedure and allows the majority of people to return to the activities that they enjoyed before experiencing hip pain.

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Anatomy
Your hip is a ball-in-socket joint.  The top of the thighbone (femur) is shaped like a ball (femoral head).  The ball fits into a cup-shaped socket (acetabulum) in the pelvis bone.  The socket holds the ball in place and allows it to rotate during motion.  The surfaces of the bones are covered with smooth cartilage that cushions the ends of the bones and allows them to move easily.

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Causes
Arthritis is a major cause of joint pain and stiffness in the hip.  Arthritis can develop for many reasons, including aging, “wear and tear,” injury, disease, and hip structure abnormalities.  Arthritis can cause the protective cartilage to wear away and lead to painful bone-on-bone rubbing.

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Symptoms
The main symptom of severe hip arthritis is dull aching pain.  You may feel pain in your hip, groin, thigh, buttock, and sometimes in the knee.  The pain may occur while you are moving or at rest.  It may even keep you awake at night.

Your hip may feel stiff.  You may have difficulty moving or lifting your leg.  Hip pain may eventually limit your every day activities, such as walking, stair climbing, and bending. 

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Diagnosis
Your doctor can diagnose arthritis by reviewing your medical history and conducting a physical examination.  You will be asked about your symptoms and level of pain.  You may be asked to perform simple hip and leg movements to help you doctor assess your muscle strength, joint motion, and hip alignment.  Blood tests and other laboratory tests may be used to identify the type of arthritis that you have.
 
Your doctor will order X-rays to see the condition of your bones and identify areas of arthritis or abnormal bone growths, such as bone cysts or bone spurs.  On occasion, your doctor may order magnetic resonance imaging (MRI) scans or a bone scan, which show additional detail.  X-rays, MRI scans, and bone scans are painless tests that simply require that you remain motionless while the images are taken.

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Surgery

Hip resurfacing is an inpatient surgery.  Your surgeon will remove damaged cartilage from the head of the femur and prepare it for the resurfacing component.  The hip socket is prepared in the same manner.  The replacement socket is placed and the resurfacing head component is attached to the femur .  The incision is closed and a drainage tube is sometimes placed to help remove fluids from the wound.

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Treatment
As your arthritis progresses, medications, rest, and physical therapy may no longer provide you with symptom relief.  However, physical therapy may be recommended following hip resurfacing. You should discuss hip resurfacing with your doctor to find out if you are a candidate for the procedure.  Ideal persons for hip resurfacing are active and younger.  Females under the age of 55 and males under the age of 65 are considered within typical guidelines.  However, hip resurfacing may be well suited for some people over the age of 60.  Inactive people, significantly older adults, or those with some specific types of arthritis are not good candidates for hip resurfacing. 

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Recovery
You will probably spend a couple of days in the hospital following surgery.  Walking with crutches begins the day after surgery.  You may be referred to physical therapy to learn low impact exercises to strengthen your hip.  Your doctor will increase your activity level and the sports you may participate in as you heal.  Recovery is individualized, and your doctor will let you know what to expect.

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Prevention

The first 6 to 12 months after receiving hip resurfacing are the most vulnerable time in the healing process.  This is when your bone grows and heals.  You should avoid heavy lifting, squatting, jogging, twisting, and high impact sports to prevent injury.  Your doctor will let you know when you can resume driving and sexual relations.

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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on April 13th, 2016. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.

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