Anterolateral Approach to Hip Resurfacing Arthroplasty: 10 Tips for the New Surgeon

Abstract

Hip resurfacing is an alternative to total hip replacement that at medium-term follow-up has had high rates of clinical success and prosthesis survival when done by experienced surgeons in appropriately selected patients. Traditional selection criteria for hip resurfacing suggest that it is most successful in active men younger than 55 years, most of whom have a diagnosis of osteoarthritic hip pain. Recent reports have suggested that high survivorships of resurfaced hips can also be achieved in wider settings, such as those of active older patients and those with osteonecrosis or developmental dysplasia of the hip. Advantages of hip resurfacing as compared with total hip arthroplasty include improved load transfer to the proximal femur, a greater range of motion of the hip joint, and more natural gait mechanics of walking. Some sources also suggest that because the proximal femoral bone is retained, conversion of a failed resurfaced hip is less demanding than revision of a total hip arthroplasty. Despite these advantages, hip resurfacing is a technically demanding procedure that requires extensive training and has a well-documented learning curve. To assist the progress along this learning curve for orthopaedic surgeons unfamiliar with hip resurfacing, this article outlines the indications for and contraindications to hip resurfacing, and offers surgical tips and techniques that can help improve the outcome of this procedure.

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