People with diseased hip joints who are relatively young, healthy and mobile--and/or who are not good candidates for a total hip replacement--may be eligible for hip resurfacing, a procedure used to restore hip function in which parts of the thighbone and pelvis are reshaped and covered with metal caps. While hip resurfacing spares substantial bone loss, it is a complicated procedure with some potentially severe risks.
Fracture of the Femur
A fracture in the neck of the thighbone, or femur, is the most commonly reported complication of hip resurfacing, according to the University of Washington School of Medicine. Doctors believe that, in some cases, fractures occur because the patients' hip joint deterioration was--in hindsight--too severe, rendering them poor candidates for hip resurfacing. However, the American Academy of Orthopaedic Surgeons notes that loss of bone mineral density in the femoral neck is also common among middle-aged and older adults; therefore, regardless of patient disease characteristics prior to hip resurfacing, femoral fractures may remain an inherent complication due to aging.
Metal Toxicity
During a hip resurfacing procedure, surgeons place metal components onto worn areas of bone in the hip joint. These metal devices rub together with movement, releasing metal ions into the bloodstream. According to the University of Washington School of Medicine, the presence of metals like cobalt and chromium in the body can theoretically increase the risk of cancer, although there is currently no definitive evidence to support this claim. Nonetheless, those with kidney disease may have trouble filtering these metals. The American Academy of Orthopaedic Surgeons cites research documenting elevated levels of metals in both the blood and urine of even those patients without kidney disease. Patients are also at risk of side effects resulting from a hypersensitivity to the proteins in these metals. Some studies have linked this reaction to osteolysis, or bone degeneration. More research is necessary to determine the long-term effects of these complications.
Surgical Failure
According to the American Academy of Orthopaedic Surgeons, hip resurfacing is a more complicated procedure than a total hip replacement. The inherent difficulty of the procedure increases the risk of failure in and of itself; however, the technical proficiency, training and experience of the surgeon also play a key role. According to the U.C. San Diego Health System, femoral fracture and a loosening of one of the components used to cover worn areas on the femur or pelvis are two reasons for surgical failure noted in published research. Revision hip resurfacing surgery or a total hip replacement may be necessary after such a failure.
Infection
Though rare, some patients may develop an infection as a result of hip resurfacing surgery. According to the U.C. San Diego Health System, doctors typically prescribe antibiotics before and after surgery to help prevent infections from occurring in the hip joint or bloodstream.
