Hip Pain

Hip Resurfacing – Frequently Asked Questions

What is hip resurfacing?

The Cormet Hip Resurfacing System consists of two parts: an acetabular component (or cup), and a femoral resurfacing component (or head).

Acetabular component: The cup is used to replace the damaged surface of your hip socket without the use of bone cement for fixation.
Femoral resurfacing component: The head is used to cover the femoral head (the ball shaped part of your hip at the top of the thighbone). The head component features a small stem that is inserted into the top of your thighbone. Bone cement is used for fixation of the head to the bone.

The Cormet head is designed to swivel within the cup. The surfaces that rub against each other are both made from highly polished metal. This type of hip device, therefore, is called a metal-on-metal hip resurfacing. All components of the hip resurfacing implants are made of standard materials that have a history of use in the human body.


Normal Hip	Diseased Hip	Resurfaced Hip

What are the potential benefits of Hip Resurfacing?

Hip resurfacing offers these potential benefits:

Bone Conserving: The procedure is bone conserving because the head of the femur is simply reshaped and "resurfaced", rather than being removed. Patients have more of their natural bone preserved. Should the device need replacing at some time in the future, this may provide better options for the surgeon at that time, as a conventional total hip replacement can typically be used.
Reduced Dislocation: The large diameter femoral head may reduce the risk of dislocation and often provides a more natural performance than traditional total hip arthroplasty.¹ Hip resurfacing helps patients resume many of the activities they enjoyed pre-operatively. This makes hip resurfacing an attractive option for younger and more active osteoarthritis patients.

Hip Replacement

How does hip resurfacing compare to Total Hip Replacement?

Resurfacing a hip is similar to a total hip replacement from a surgical perspective. Instead of cutting off the arthritic top of the thighbone (femoral head), the head is reshaped and resurfaced with a metal mushroom-like cap. This is secured in place with a type of bone cement. The hip socket (acetabulum) is prepared in a similar fashion to a total hip replacement. Once the diseased cartilage is removed, a cup is press-fitted into place. Hip resurfacing leaves more of your natural bone in place and does not remove the thighbone (femur) neck shaft.

Is Hip Resurfacing for everyone?

An orthopedic surgeon can decide if a patient meets the criteria for a hip resurfacing procedure or a total hip replacement.

Hip resurfacing is most appropriate for younger, more active patients with:

Good bone quality
Osteoarthritis
Rheumatoid arthritis

Hip resurfacing is not recommended for patients with the following conditions:

Active or suspected infection in or about the hip joint
Poor bone quality which your surgeon feels could not support the implant
Multiple cysts
Any known allergy to metal (e.g., jewelry)
Extreme overweight (overload on device that would lead to failure)
Skeletal immaturity
Women in child-bearing years
Weak immune system due to disease or certain medications (e.g., corticosteroids)
Kidney failure

Your orthopedic surgeon is the only person who can advise you whether you are suitable for hip resurfacing.

What is the right implant for me?

There are many different designs of implants and the choice of implant to be used is at the discretion of the surgeon. Some implant choices are based on surgeon preferences, others relate to the age, lifestyle and clinical condition of the patient. The important thing is to understand what implant or treatment your surgeon recommends and why.

Some patients are not suitable for Hip Resurfacing, usually because their bone quality is not sufficient to support this type of device. However, the potential benefits of a large-diameter bearing surface may still be provided by using a Stryker total hip implant. In this case, either a metal or ceramic head and advanced polyethylene implants are used. This implant is designed to provide the patient with a similar opportunity for lifestyle recovery as a resurfacing implant, but with a femoral stem.

What is the clinical success?

For the vast majority of patients, joint replacement can be successful in providing relief from pain and improved mobility for many years. Hip replacement in particular has become one of the most successful surgical procedures, with a success rate of over 90% in the US.² The Cormet Hip Resurfacing System has proven clinical experience.¹

What are the potential risks and complications?

The usual risks associated with joint replacement apply. There is a low risk of major complications due to infection or early loosening¹, which may lead to the need for further surgery. Other possible complications include dislocation, the femoral neck fracturing after surgery, audible noise during motion and allergic reactions. Your surgeon will advise you of any risks involved in your specific procedure.

What can I expect after the operation?

After surgery you will need to rest your hip to allow proper healing. Your activity will be restricted during this healing period. During the first weeks after surgery, you may be advised to put a pillow between your legs when turning over in bed, wear elastic stockings, use raised toilet seat, take showers rather than baths, restrict activities such as sudden twisting or turning, crossing legs, exposing the scar to sunlight, and driving. Follow carefully your surgeon's instructions regarding progression to normal weight bearing and resumption of normal physical activity. Individual results will vary and all patients will experience different activity levels post-surgery.

Even after the healing period, excessive loads placed on the implants through sudden trauma or high impact activities, such as running and jumping, can damage the artificial joint.

The majority of your therapy and rehabilitation will occur once you are discharged from the hospital. Your physical therapist (PT) should design an exercise program to increase the motion and strength of your hip and should make sure that you know proper form before you begin the program. The rate and effectiveness of your rehabilitation is critically dependent on your commitment to the physical therapy program as well as other clinical factors.

You will be given detailed post-operative instructions by your surgeon before you leave the hospital. If you want specific exercises which will aid your recovery, ask your surgeon or the physiotherapy department at your hospital.

To what extent will my activities be restricted after Hip Resurfacing?

While you are in hospital, you should listen carefully to the advice from your surgeon, physical therapist, or occupational therapist. It is important that you adhere to their instructions and ensure that you comply with any exercise regime that they recommend.

You will certainly need help and support when you return to your home – the amount of support being dependent on your general physical condition and the type of surgery you have had. You may be advised by your surgeon to walk with a cane or crutches for some time after your operation in order to relieve the amount of load on your operated joint.

While joint replacement surgery can provide relief for chronic and debilitating pain, you must remember that it will take some time for your muscles and other joints to recover to a more normal range of movement; therefore it is not realistic to expect an instant return to normal levels of activity.

How long will the implant last?

This will depend on a number of factors, including the extent of your osteoarthritis, your physical condition, weight and your post-operative activity levels. Your doctor will help counsel you about how to best maintain your activities in order to potentially prolong the lifetime of the device.

References:

PMA P050016, Summary of Safety and Effectiveness.
Ehealthmd.com, June 2007.

This material intended for US Distribution only.

Manufactured by Corin. Distributed exclusively by Stryker Orthopaedics in the USA.
Cormet is a registered trademark of Corin PLC.

For Hip Resurfacing indications, contraindications and risk information, see the Cormet Patient Labeling