What is Birmingham Hip Resurfacing?
Birmingham Hip Resurfacing (BHR) surgery is a specialized orthopedic procedure designed to address hip joint problems, particularly in younger, active individuals. Developed in the United Kingdom, the procedure aims to alleviate pain and restore function in patients suffering from hip arthritis or other degenerative conditions. Unlike traditional hip replacement, which involves replacing the entire hip joint, hip resurfacing involves capping the femoral head with a metal covering while preserving the majority of the natural bone. This approach offers several advantages, particularly for younger patients with higher activity levels, due to the preservation of more natural bone structure and potentially improved joint mechanics.
Indications for Birmingham Hip Resurfacing Surgery
The Birmingham Hip Resurfacing surgery is typically recommended for individuals who:
- Have Significant Hip Pain: Persistent pain that limits daily activities and quality of life, despite non-surgical interventions.
- Suffer from Hip Osteoarthritis: Degenerative arthritis leading to the breakdown of cartilage in the hip joint.
- Are Younger and More Active: The procedure is often favored for younger patients who are likely to outlive the lifespan of a traditional hip replacement due to their higher activity levels.
Procedure Overview
Birmingham Hip Resurfacing surgery involves several key steps:
Preparation and Anesthesia: The procedure is performed under general anesthesia or regional anesthesia, ensuring the patient is pain-free and immobile during the operation.
Accessing the Hip Joint: The surgeon makes an incision over the hip joint, typically along the side of the hip. The muscles and tissues surrounding the joint are carefully moved aside to access the hip joint.
Resurfacing the Femoral Head: The surgeon removes damaged cartilage from the surface of the femoral head (the ball-shaped top of the thigh bone) and reshapes it to fit a metal cap. This cap is then precisely fitted onto the femoral head, covering the damaged bone with a smooth metal surface.
Preparing the Acetabulum: The surgeon prepares the socket of the hip joint (acetabulum) to receive a metal cup. This metal cup is implanted into the acetabulum, ensuring a stable fit and alignment with the resurfaced femoral head.
Repositioning and Closing: Once the metal components are securely in place, the hip joint is repositioned. The surgeon then carefully closes the incision using sutures or staples, ensuring proper alignment of the soft tissues and muscles.
Recovery and Rehabilitation: After the surgery, the patient is taken to a recovery area where they are monitored as they wake from anesthesia. Initial recovery focuses on pain management and mobility.
Postoperative Care
Following Birmingham Hip Resurfacing surgery, patients typically follow a structured care plan:
- Pain Management: Pain control is managed to ensure comfort and facilitate the early stages of recovery.
- Physical The*rapy: A rehabilitation program involving physical the*rapy is crucial to help the patient regain strength, flexibility, and range of motion. The*rapy often begins with gentle exercises and gradually progresses to more intensive activities.
- Mobility Aids: Patients may use mobility aids, such as crutches or a walker, to assist with movement and reduce stress on the healing hip joint.
Recovery and Rehabilitation
Recovery from Birmingham Hip Resurfacing surgery involves several stages:
- Hospital Stay: Patients typically stay in the hospital for 1 to 3 days post-surgery, depending on their individual progress and any complications that may arise.
- Gradual Mobilization: Early movement is encouraged to prevent complications such as blood clots and to support the healing process. Patients generally start with walking and gradually increase activity levels under the guidance of their healthcare team.
- Long-Term Rehabilitation: A comprehensive rehabilitation program helps patients regain full function and adapt to their new hip joint. This includes strengthening exercises, balance training, and eventually returning to regular activities and sports.
Advantages of Birmingham Hip Resurfacing
The Birmingham Hip Resurfacing procedure offers several advantages, particularly for younger, active patients:
- Bone Preservation: By preserving more of the natural bone structure compared to total hip replacement, patients maintain better bone quality and joint mechanics.
- Reduced Risk of Dislocation: The large metal-on-metal contact surface of the resurfaced joint often reduces the risk of dislocation.
- Greater Range of Motion: The procedure typically provides a greater range of motion and allows patients to return to high-impact activities and sports sooner than with traditional hip replacements.
What is Hip Resurfacing and how is it Different from Hip Replacement?
This procedure differs from the traditional hip replacement method where the entire hip joint is replaced completely leading to maximum bone loss, a situation that might not be favorable for younger patients. However, the hip resurfacing surgery needs to be done under an experienced medical team since it involves careful alignment of the metal caps in order to avoid future complications after the surgery.
The Hip Resurfacing Surgery is Not Appropriate on these conditions:
- If the patient is pregnant
- If the patient’s bone health is weak or filled with multiple cavities
- If the patient has a kidney disorder
- If the patient is sensitive to metal
- If the patient is overweight or obese
- If the patient has chronic blood or bone infection
- If the patient has an immunity disorder due to diseases such as AIDS.
Risks and Complications
Like any surgical procedure, Birmingham Hip Resurfacing carries potential risks and complications, including:
- Infection: Risk of infection at the surgical site or within the joint.
- Bleeding: Potential for bleeding during or after the surgery.
- Dislocation: Risk of the hip joint components becoming dislocated, particularly in the early stages of recovery.
- Implant Failure: Although rare, there is a possibility that the metal components may fail or wear out, necessitating further intervention.
- Leg Length Discrepancy: Potential for a difference in leg length following the procedure, which may require adjustment or correction.
Birmingham Hip Resurfacing Surgery Precaution & Care
Pain or soreness in the muscle or hip joint is normal after the surgery. The pain or soreness might be prominent near the incision area including chances of fluid leaking in and around the incision. While doctors prescribe pain medications for the soreness, fluids yellow or white in colour should be reported to the doctor immediately, especially, if the fluid draining is accompanied by redness or swelling. However, minimum fluid leakage is actually normal for this treatment.
There are no special diet regulations but it’s always better to check in with the medical team regarding diet to avoid interaction with medications prescribed. Based on your recovery rate, the medical team may ask for imaging scans or will advise you for physical therapy. A cane or a crutch for the initial recovery days might also be prescribed. Doctors will also determine when the patient can start applying pressure or go back to their normal lifestyle.
FAQs
How long do I have to stay in the hospital after a hip resurfacing surgery?
About 4-5 days hospital stay is needed.
How fast can I recover from the hip resurfacing surgery?
Usually, patients can start walking after 4 hours of the surgery, but that is completely based on the patient’s recovery rate. Doctors usually keep 2-4 weeks as the general recovery period.
Do I have to undergo hip resurfacing a second time?
Taking wear and tear into account, patients after 10-20 years might have to reappear for a resurfacing or total replacement surgery based on their condition.
Is this surgical procedure safe?
This surgery was approved by FDA in 2016 and so far 3000+ hip resurfacing surgeries with successful results have been performed.
Can I run after my hip resurfacing surgery?
Clinical documentations say running is possible after this surgery. However, long-term effects such as wear and tear are not calculated in this documentation. Your doctor will be able to guide you better on this.