Resurfacing Cups

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Resurfacing Heads

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Resurfacing Hip

Fixation

Fixation of the cup in hip resurfacing is with a press-fit fixation initially.  The surface of the cup on the outside is such that bone will grow into it to anchor it in place.  The fixation on the femoral side is with cement.  The resurfacing does not rely on a stem to go into the femoral canal around which the cement can get a grip. The femoral resurfacing chamfers the femoral ball and is then cemented over the top of this chamfered bone.  This means on the femoral side that only a minimal amount of bone is removed.  It does however mean that the bone within the femoral neck is relied upon to give support.  Particularly in women, the quality of this bone becomes poor as the patient gets older with an increased risk of osteoporosis.  For this reason a resurfacing tends to be done more frequently in men and of a younger age group.

The bearing surface

The bearing surface is a metal on metal bearing surface.  Because of the design of the component the metal head accurately reflects the true size of the femoral head and this gives a very natural feeling hip.  The bearing surface is described as metal on metal but in fact will have a film of fluid between the two metal surfaces.

Stability

The large metal head gives the resurfacing excellent stability.

Durability

The long-term results of hip resurfacing are not yet known.  Over the years hip resurfacing has failed, primarily because of manufacturing problems.  The newer manufacturing techniques have allowed a much better resurfacing to be made and with this it is expected that the results will be better.  Over the next few years 10 year results will become available on the modern resurfacings.

Extra large heads

The benefit of the resurfacing described above appears to be the bearing surface with a femoral head which is of normal anatomical size.  This appears to give a natural feeling hip.  The big disadvantage is that it can only be used on patients with good quality bone.  The other disadvantage is that access to the hip is difficult because the head is retained.  This means it is difficult to do the operation through a small incision.  An increasingly popular joint replacement is now to combine the resurfacing head with a femoral stem.  The head is placed onto the stem with a Morse taper to allow the benefits of the resurfacing technology to be put onto a more conventional stem.