Resurfacing Arthroplasty
  HIP Replacements
  Total Hip Replacements
  Knee Replacements
  Oxford Unicondylar Knee Replacements
  Surface Replacement of the Shoulder

Mr. K.Singhal
Consultant Orthopaedic Surgeon
Princess of Wales Hospital Bridgend
BUPA Hospital Cardiff.
Resurfacing arthroplasty implies removing the diseased and roughened surface of the joint and replacing it with highly polished artificial surfaces designed to glide easily on each other thus relieving pain.

Resurfacing has been the preferred and accepted mode of joint replacement in the knees for many years and virtually all routine knee replacements done these days are resurfacing procedures.

In the hip however the concept of resurfacing has gained acceptance only in the last five years or so.

The X Ray and picture above show a Birmingham Hip Resurfacing developed by Mr. Derek McMinn of Birmingham. As is obvious from the illustrations, the femoral head and neck are not sacrificed, but trimmed to remove the diseased and sclerotic bone. Subsequently a large superfinished cobalt chrome ball is cemented to the remaining head and neck. The size of this ball is much like that of the normal hip leading to increased stability. On the socket side, a thin highly polished metal shell with hydroxyapatite coating is implanted. The coating encourages bone ingrowth into the beaded surface of the shell ensuring a firm bonding with the acetabular bone.

The advantages of the resurfacing procedure are:

Preservation of bone, which is very important in young patients.
Better stability because of the large size of the ball.
Conservation of bone strength because the head and neck of the femur are loaded physiologically.
Elimination of polyethylene wear debris which are known to cause osteolysis and loosening of conventional hip replacements.

Because of these advantages, this procedure is ideally suited in young patients with higher functional demands and more active lifestyle. If the hip does need revision a few years down the line, it is possible to do a conventional hip replacement as if it were being done the first time, because the bone stock is intact.

This hip is being used with increasing frequency in U.K. and also in United States. It must however be recognised that very long term results of this hip are not yet available. The early results with up to seven years follow up suggest that this hip works very well in the short to medium term.

Our own early results with this hip in the short term have been very encouraging.
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