Hip arthritis - is there an option to surgery?
Hip arthritis
The usual treatment: If you develop mild to moderate forms of osteoarthritis of the hip in your 40s, you’re usually told to wait until you’re 55 or 60 for a full or partial hip replacement, in which the entire neck and head of the thighbone (the femur) or just the head are replaced with metal parts. Though it may mean tolerating limited movement and chronic pain, there’s a reason for waiting: Metal hips last up to 20 years, and in a recent British study, they lasted this long in only half of osteoarthritis patients under age 40.
Hip resurfacing
Pros: Available to middle-aged arthritis sufferers; marked pain improvement in almost 98% of recipients 5 years later; nearly all patients satisfied
Cons: Data goes back only 9 years; unclear how long resurfacing delays full hip replacement. Femur fractures occur in 1.5% of patients, though they’re twice as likely in women; a doctor should check your bone density first
Smart option: Hip resurfacing. In this procedure, surgeons reshape the top of the thighbone and cover it with a metal cap that sits inside a thin metal hip socket, blocking painful nerve endings on both sides. More bone is left intact than with a replacement, which makes any future surgeries or adjustments easier to perform and more likely to be successful.
Why it may be better: Instead of suffering for years until they qualify for a hip replacement, patients experience “a nearly complete end to pain,” says William Macaulay, MD, director of the Center for Hip and Knee Replacement at New York–Presbyterian Hospital/Columbia. The FDA-approved Birmingham Hip System was still providing pain relief 5 years after surgery in 98% of patients during clinical trials. In foreign studies, 98% of resurfacing recipients in eight countries were satisfied 7 years later.
Why it’s kept quiet: Hip resurfacing hasn’t been available in the United States for very long — the procedure was approved by the FDA in 2006 — and some doctors with many years of hip replacement experience are skeptical because it’s so new, says James Rector, MD, an orthopedic surgeon in Boulder, CO. Additionally, there’s not much long-term data on its efficacy yet — only 9 years’ worth, to be exact. These factors explain why it makes up less than 4% of current US hip surgeries.
Real-life endorsement: By age 42, Charlie Post had arthritis in his left hip that made it impossible for him to sleep comfortably, and the Bantam, CT, resident could no longer hit the ski slopes with his three teenage sons. Three different doctors told him he was too young for surgery. “One said I’d have to be walking with a cane before I had a total hip replacement,” Post says. A year later, he read about resurfacing on the Internet; less than a month after surgery, he was almost entirely pain free and able to sit comfortably in cars and planes again — even skiing with his sons by the end of that season. Though he might still need a replacement someday, “ultimately, it was worth it,” he says.
