In this video I'm going to be answering the question is hip resurfacing surgery better than
hip replacement surgery. My name is Dr. David Middaugh. And I'm a
specialist physical therapist at El Paso manual physical therapy.
And this channel is dedicated to helping people stay healthy, active and mobile,
while avoiding unnecessary surgery, injections and pain medications. Please consider subscribing
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So let's first answer the question what is hip resurfacing surgery, it's a much rarer surgery
than hip replacement surgery. And so you may be watching this video and that never heard of hip
resurfacing surgery. So let's just describe the procedure here. So here's the hip joints,
the make sure we're in the frame here, there's the ball and inside there is the socket and in hip
resurfacing surgery is what is done is the outer part of the ball and the outer part of the socket.
So the surfaces are the only parts that are replaced. So it is actually technically a
replacement surgery. But it's kind of a light version of a full hip replacement surgery.
So only the outer part right here the ball is replaced, they leave a lot of bone,
they preserve a lot of the bone in the thigh bone right here at the top of the hip.
And they do have a small stem that goes into the neck of the femur here, this structure is
called the neck of the femur, the thigh bone. And then on the inside part, they put a socket
a metal socket. And so one unique thing about this as it is metal on metal, which is in typical
in a hip replacement surgery is typically some plastic, a very durable plastic on a metal ball,
which reduces the likelihood of metal shavings and other problems going on. Although those are rare,
that technically does happen from time to time, and it may or may not be harmful. In your case,
a hip resurfacing procedure is typically done on younger patients.
So we're talking patients that are in their 50s or even younger, some of these people have arthritis,
it sets that that is that bad or there's other conditions that have damaged the surfaces of the
hip joint. And that might be the reason for having the hip resurfacing procedure done. Now one of the
requirements is that not too much damage is done. Because if they're if the parts that they're going
to cut off for the hip resurfacing procedure, if they're only looking to cut off the damaged parts,
but if the damage goes deeper than that farther into the bones and that then you're
probably going to have to have a hip replacement surgery if you're looking at getting surgery.
Now let me answer the question. How is this different from a hip replacement and
traditional hip replacement surgery? Well, on traditional hip replacement surgery, the socket
is replaced very much like the hip resurfacing surgery, except you're going to have a plastic
and on the socket side. On the femur side in the thigh bone side, the entire neck of the
thigh bone here is cut off and removed. And then the whole head of the femur,
the thigh bone here the whole ball of the ball and socket joint is going to be artificial versus
a resurfacing procedure, you would still have some of the bone there. And then they have to
insert a stem of the prosthetic the metal part has a stem that goes into the shaft of the bone
a decent way in order to anchor the artificial replacement part of the hip onto the bone.
And so as a result of that it is a more invasive surgery meaning more surgery is done
and that requires a longer healing time versus the hip resurfacing surgery it requires a lesser
healing time. Some other differences to note is that a hip resurfacing surgery requires more
precision more skill by the surgeon and as a result of that most surgeons doing hip resurfacing
have to go through extra training and so your typical hip doctor, hip surgeon
is probably not going to offer hip resurfacing, you have to make sure you find a surgeon
that's gone through the training to do this. So typically they're fellowship trained surgeons,
and they're usually going to be in the bigger cities. So if you're watching this video
right now and you're thinking, Oh, maybe a hip resurfacing procedure is right for me it might be
but you might have to travel to go find a surgeon that actually does them confidently,
because for hip surgeons doing total hip replacement is probably their bread and butter.
That's what they do all the time. But to ask them to do a hip resurfacing procedure is
going to be something that they're just not used to doing and maybe not experienced or confidence
in doing it so they may not even offer it to you and They may not even offer it because it's
not the right thing for you, you have to kind of qualify to be a candidate for a hip resurfacing
procedure. Now as far as qualifying or being a candidate for hip resurfacing, usually it's
going to be people in their 40s and 50s. Those are the ones that tend to get the
hip resurfacing procedures and the surgeons doing these are also looking at how active
you're going to be because typically, the hip resurfacing is done for people that intend to
get back to exercising vigorously, maybe even doing some jogging, yoga, possibly even skiing,
doing kind of impactful activities. Because with removing with a procedure, removing less bone,
the hip resurfacing procedure, your body can tolerate that a lot better. There's also a little
less risk for dislocation with hip resurfacing. Now there's risk for dislocation with any
hip surgery, any of these two hip surgery procedures that we're talking about.
But generally speaking, the ball of the hip resurfacing procedure tends to be bigger, which
makes it a little less susceptible to dislocating. So the next question you might have is, when is
it best to get a full a total hip replacement, I can tell you, most surgeons, if you're 65,
or older, most surgeons are going to tell you, you just need to get the replacement done.
Don't even bother with the resurfacing, of course, it's going to be an individual
decision, you know, based on you and if you talk to a doctor that does do hip resurfacing, you have
to have a long talk about it. And they're going to be looking at how well how healthy the bone is in
the ball and in the neck of your thigh bone here. Because if it's not as healthy as it should be,
if you got some thinning bone, some osteoporosis or osteopenia, as long as it's not too severe,
then they might, they might say you don't you qualify for a hip resurfacing procedure.
Or if it's to thin the bone, then you don't qualify for hip resurfacing procedure,
because it won't last your bones too thin, you're going to suffer a break later on. And
they don't want to have to go in and do a second surgery because you broke your hip.
So they'll just replace the whole thing and do a total hip replacements,
there is research to show as well that older people meaning people in their
60s relative to the people in their 50s and 40s, getting the hip resurfacing procedures,
older people tend to just do better with a hip replacement surgery.
So doctors are going to be less likely to even offer it because of those statistics.
Doctors don't want their surgeries to fail. And so they want to make sure they put you
in the best position possible to not have some bad outcome, like a hip dislocation or
some other problem that could be related to your hip surgery. And the next most common
question we get is which one lasts longer? Because if you have to have a hip surgery,
you have you want to only have one, not more than one. And if you're younger, especially, you know,
there's you hear things out there like oh, this these components only last 20 years, or 10 years
or 25 years. They're extending all the time. But that's a question which one lasts longer.
Currently, the evidence the scientific research is leaning more towards hip resurfacing lasting
a bit longer. But to give you the other side of the coin, usually people getting
hip replacements are already older. So generally doctors will say this is
going to last you the rest of your life, as long as you don't live to be 99 years old,
you're probably not going to need it. And even then your function is you know,
who knows what your function is going to be like at that point. And if you're going to be able to
sustain another surgery based on your health. So it's that's a factor to consider.
But it's not conclusive right now as to which procedure lasts longer. And the reason for this,
in my opinion, is we don't have research, we just don't have enough studies done. That's one factor.
But the other factor is what surgeons don't fix. And that's the underlying root problem
that develop the hip arthritis that got you to this point that you're thinking about getting a
hip procedure done like a hip resurfacing surgery, or a hip replacement surgery.
So I would ask you the question, Is it maybe a possibility that maybe you don't need surgery,
maybe having a hip replacement or a hip resurfacing surgery is not necessary for
you. The fact of the matter is when we see clients here in the clinic at our manual therapy clinic,
nine out of 10 cases really more than nine out of 10 cases of hip pain, hip arthritis problems,
they get better, doing natural things that we offer here in the clinic, which is mainly
exercise that's what you have. under your control. You can go exercise once you learn how to exercise
correctly once you figure out which muscles need to be exercised, the rate, the frequency,
the intensity, all those factors. Once you work them all out and figure out how to progress it
over time. Very often. You can depressurize a bone on bone hip joint, and begin to get more freedom
of motion, reduced the inflammation reducing irritation, which in turn reduces the pain
and increases the mobility and gets most people to the point where they say, You know what,
I can live with this little bit of hip pain. But I can sleep at night, I can walk for a good
long period of time. I think if I continue to strengthen in exercise, maybe it'll even improve
more. We often see people get those results and have them avoid having the surgery,
delaying a surgery, or at the very least, let's talk worst case scenario.
If you get stronger, improve your mobility, and decrease your pain and you still think that
you need to have a hip surgery done. Whether it's a resurfacing or a hip replacement done,
at least you're stronger now. And if you do have a surgery, you're going to recover
better and faster afterwards. And I don't think anybody's going to deny that so you
can't lose by strengthening your hip joint. Sorry about your joint strengthening the right
muscles around your hip, which is usually the glutes very often it's the glutes. If
you get those stronger, your hip tends to be a lot happier. Whether or not you have to have surgery.
We've got lots of videos on how to handle hip arthritis, even bone on bone, hip arthritis, lots
of videos covering advice exercises, understanding the process of how it works, how to progress it,
of course, stretches and exercises and in devices that you might use to get some pain relief.
They're all in a playlist called hip arthritis help and it's linked in this description for
this video below. Just hit that See More button those letters see more and the description will
drop down and scroll down and you can find the playlist for hip arthritis help and begin to
watch more of our videos on how to help your hip arthritis problem. I hope this video was
helpful for you in understanding hip resurfacing versus hip surgery a hip replacement surgery.
If you thought it was please give us a thumbs up and share this video with somebody who's
got a hip problem so that they might learn about this and avoid having surgery or at
least choose the right procedure for them so that they know what to do for their hip.
Thanks so much for watching and I hope to see you in the next video. Bye