New Hip Replacement Technique Offers Promise To Young, Active Patients

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Hip Replacement Surgery

Hip replacement surgery is no longer just for seniors.

When you hear about someone needing hip replacement surgery, what image comes to mind? A woman in her 60s or 70s who has suffered a broken hip due to osteoporosis? An elderly man who has severe arthritis in his hip joint?

At Scripps Memorial Hospital La Jolla, orthopedic surgeon Michael Kimball, M.D., has been seeing numerous patients in their 40s and 50s who are already experiencing severe osteoarthritis. An estimated 40,000 American men who suffer from osteoarthritis in the hip are under age 65.

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According to Dr. Kimball, traditional total hip replacement surgery can alleviate the pain of osteoarthritis, but it also can mean an end to vigorous physical activity such as jogging or tennis. During total hip replacement, the surgeon removes the entire head and neck of the thighbone, and replaces it with an artificial implant. Most implants used in traditional hip replacement are significantly smaller in size than the anatomy of the bone they replace. As a result, the implant may becomedislocated, which is a leading cause of implant failure. In addition, differences in leg length can be a common concern following hip replacement surgery.

"Even when the surgery has no complications, patients may have to have another procedure down the road," says Dr. Kimball.

So what is a younger, physically active adult to do if he or she needs hip replacement surgery? The answer may be the Birmingham Hip Resurfacing (BHR) technique, a relatively new, clinically proven alternative to total hip replacement recently introduced in the United States. In use overseas since 1997, the BHR technique is intended for physically active patients who are under the age of 65 and suffer from hip arthritis or other degenerative joint diseases. In many cases, hip resurfacing can help these younger patients regain their active lifestyles without pain.

Rather than replacing the entire hip joint as with total hip replacement, hip resurfacing simply shaves few millimeters of bone within the joint and caps it with an implant, much as a cap covers a worn-down tooth. Consisting of a metal ball pivoting inside a metal socket, the Birmingham hip implant is made from tough, smooth cobalt chrome, so there are no plastic parts to replace. Moreover, because the implant closely matches the size of the thighbone head, it is substantially larger than the head of a traditional total hip replacement implant. This increased size translates to greater stability in the new joint, thereby decreasing the chance of dislocation after surgery.

Unlike total hip replacement, hip resurfacing leaves the head and neck of the thighbone untouched (something that can prove to be valuable if a patient does need to undergo a total hip replacement later on in life). Since the neck length and angle determine the natural length of a patient's leg after surgery, there is a greater likelihood of maintaining accurate leg length after surgery.

To date, the Birmingham hip implant has been implanted in more than 60,000 patients in 27 countries. Patients have been extremely pleased with the results; in a study of more than 1,600 patients, 99.5 percent reported that they were "extremely pleased" or "pleased" with the Birmingham Hip Replacement. Patients also have reported that they have returned to running, soccer and other sports.

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