Midlands Orthopaedics & Neurosurgery

Why Choose Hip Resurfacing?

Expert Hip Resurfacing Specialist in Columbia, SC

Why Choose Hip Resurfacing?

Hip resurfacing is a cutting-edge procedure ideal for those seeking a near-normal joint post-surgery, especially athletes or individuals engaged in heavy physical work. Unlike total hip replacement (THR), hip resurfacing maintains a more normal gait even at higher speeds and is suitable for impact sports.

Understanding Joint Degradation:

Severe arthritis in the hip erodes the hyaline cartilage, causing bone-on-bone pain, particularly during weight-bearing or impact activities. Current treatments like stem cell injections or microfracture during hip arthroscopy offer limited relief, especially in larger defects. Joint replacement becomes the only viable solution for significant cartilage loss.

The Surgery Process:

In joint replacement, the cartilage and some bone are replaced with artificial surfaces, recreating joint movement and protecting the bone, similar to the original joint. However, an artificial joint is never fully “normal,” with imperfect healing and biomechanical differences influencing the outcome.

Hip Resurfacing vs. Total Hip Replacement:

Hip Resurfacing Arthroplasty (HRA) provides a closer biomechanical mimic to the natural hip, sacrificing only a thin layer of bone, thus maintaining stability and normal load transfer. In contrast, THR often involves a larger metal stem and a smaller bearing size, leading to a less stable and biomechanically altered joint, limiting high-impact activities.

Durability and Longevity:

Hip resurfacing boasts impressive durability, with a 99% implant survivorship at 13 years in Dr. Gross’s practice. International studies support these findings, especially in younger, active patients. In comparison, THR shows a higher failure rate in younger patients, with a 10-year implant survivorship as low as 80% for patients under 50.

Hip Stability:

Hip resurfacing has a significantly lower dislocation rate (0.3%) compared to THR (about 3%). It allows for more extreme motion activities post-recovery, like yoga, ballet, or kayaking, which might be risky with a THR due to its inherent instability.

Bone Preservation:

HRA is particularly advantageous for younger patients who may require future revisions. It preserves more femoral bone compared to THR, making any potential future surgeries less invasive and more straightforward.

Enhanced Patient Survivorship:

Studies indicate a 20% lower mortality rate among HRA patients compared to THR patients over 10 years, possibly due to the increased likelihood of engaging in regular, vigorous exercise post-surgery.

Reduced Risk of Debris Failure:

HRA now presents a lower risk of debris failure compared to THR. The last wear failure in HRA was over 12 years ago, demonstrating the efficacy and safety of the procedure.

Hip resurfacing is a superior option for active individuals seeking a solution that closely mimics the natural hip. It offers enhanced durability, stability, bone preservation, and a lower risk of debris failure. It is ideal for younger patients or those aspiring to maintain an active lifestyle post-surgery.

For more information or to schedule a consultation, contact us at (803) 256-4107.

Experience the difference with Hip Resurfacing Arthroplasty. Don’t let hip pain hold you back. Join the countless individuals who have regained their active lifestyles, thanks to this innovative procedure. Schedule your consultation today and take the first step towards a pain-free, active future. We serve patients from Columbia, SC, Irmo, SC, Lexington, SC, and surrounding areas.


Your content goes here. Edit or remove this text inline or in the module Content settings. You can also style every aspect of this content in the module Design settings and even apply custom CSS to this text in the module Advanced settings.

Why Uncemented Implants?
All HRA use uncemented bone -in growth fixation on the socket side. Most brands including the BHR are cemented on the femoral side. We have demonstrated that uncemented fixation on the femoral side gives superior results to cement. Cement is a brittle acrylic material that heats up during implantation (polymerization reaction) burning the femoral head and increasing the chance of early femoral failure. It also is subject to fatigue failure over time resulting in implant loosening type failure. With uncemented femoral components we have had a 100% bone ingrowth rate. 0.4% fail due to neck fracture or head collapse, only 1/5000 has come loose since 2007. My femoral loosening rate with cement was 1% by 10 years when I used cement before 2007. We can demonstrate no difference in the early femoral failure rate between cemented and uncemented femoral implants. The difference in late loosening between cemented and uncemented femoral is 1% vs 0.05% at 10 years, this is statistically significant.
Why Minimally Invasive Surgery?
With a minimally invasive 4-5 inch posterior approach, minimal blood loss, and multimodal pain management, outpatient surgery is possible. This is more convenient, pleasant and less costly. Since 2012 we have perfected this outpatient approach for all joint replacement procedures and over 80% of my operations are done this way. Local patients return directly home on the day of surgery, out-of-state patients stay in a hotel for 1-2 night before travelling home. Patients with certain major medical comorbidities, uncooperative insurance plans, or those without capable caregivers are still done at the hospital with a one night overnight stay. I strongly recommend against stays at rehab facilities unless a patient cannot arrange any support at home.
Accurate X-ray Based Component Positioning
The most critical factor in consistently achieving excellent outcomes in resurfacing is accurate acetabular component positioning. Adverse (Metal) Wear Related Failures (AWRF) can now be completely avoided, even in higher-risk patients requiring smaller implant sizes, by proper acetabular component positioning. We published the world’s first component positioning guideline that is supported by data. We named it RAIL: relative acetabular inclination limit. We then developed intraoperative x-ray techniques that allow us to achieve the RAIL in every case. We monitor all patients for excessive wear using blood ion levels. As a result, we have not created a single AWRF since 2009 (10 years, >4000 cases). Prior to 2007 the rate was 1% at 10 years.
Is Resurfacing Safe In Women?
Yes. Durability is equal to men in the last 10 years. Early data from many centers indicated that women had a higher risk of failure due to femoral neck fracture, failure of acetabular ingrowth and adverse metal wear related failure (AWRF) than men did. I have data to show that I have solved all of these problems at least 10 years ago. Ten-year implant survivorship in women is now 99%; it is now equal to that in men. Femoral neck fractures are rare (0.2%). A trispike acetabular component introduced in 2007 has eliminated the acetabular component failures in deformed dysplasia sockets (90% of dysplasia occurs in women). Understanding proper acetabular component positioning has allowed us to implant acetabular components to avoid AWRF (no new cases since 2009).
Solving the Problems of Revision Failed Resurfacings
Our published results are nearly as good as for primary surgery. Others have also published excellent results for revision of hip resurfacing. Most reports on revision for the problem of adverse wear related failure (AWRF), however are poor. The worst report is from Oxford, with a 50% short-term failure rate. We have experienced a 100% success rate for AWRF by revising these failures with new large metal bearings placed correctly according to new implant positioning guidelines that we have developed.
Happy Hikers Img
The physicians and physical therapy department at Midlands Orthopaedics & Neurosurgery will ensure the most comprehensive approach to help find relief for you in the quickest way possible.