There are several potential disadvantages of hip resurfacing that should be considered. It is important to note that while these negatives exist, they may not necessarily apply to every individual undergoing the procedure.
1. Increased difficulty to perform the procedure: Hip resurfacing is a technically demanding surgery that requires a high level of skill and experience from the surgeon. Compared to total hip replacement, resurfacing can be more challenging due to the need to precisely shape and fit the metal cap on the femoral head. This increased complexity may limit the availability of surgeons who are proficient in performing hip resurfacing, meaning that patients may have limited access to this procedure.
2. Increased acetabular bone stock loss: In hip resurfacing, the femoral head is reshaped and a metal cap is placed over it. This means that more bone needs to be removed from the femoral head compared to traditional hip replacement surgery. This can result in greater loss of bone stock in the femoral head, which may pose challenges for future revision surgeries if needed. In cases where there is already significant bone loss or osteoporosis, hip resurfacing may not be a suitable option.
3. Femoral neck fractures: One of the potential complications of hip resurfacing is femoral neck fractures. This occurs when the neck of the femur, which is preserved in resurfacing, fractures due to stress or weakness. While the incidence of femoral neck fractures has decreased over time with advancements in surgical techniques and implant design, it remains a concern, especially in older patients and those with weaker bones. These fractures may require additional surgery to repair or replace the implant.
4. Concerns about the effects of metal ions: Hip resurfacing involves the use of metal-on-metal implants, where both the femoral head and acetabular component are made of metal. During normal wear and tear, these metal components can release metal ions into the surrounding tissues and bloodstream. This can lead to a condition called metallosis, which is characterized by local tissue damage and systemic symptoms such as pain, inflammation, and potential toxicity. While advances in implant design have reduced the occurrence of metallosis, it is still a potential concern in hip resurfacing.
It is important for patients considering hip resurfacing to discuss these potential disadvantages with their healthcare provider. Each individual’s circumstances and medical history should be carefully evaluated to determine if hip resurfacing is the most appropriate treatment option.