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Hip Resurfacing

You will hear about a procedure that resurfaces only the femoral head, the ball side of the ball and socket joint of hip. It doesn't require the removal of the head of the femur, nor does it need an implant placed inside the femur (thigh bone). You're not cutting any bone; you're just sculpting the cartilage away and putting a skull cap, a "hat," on the ball. A short stem fixes it into the femoral head. The implant is made of cobalt chrome, so it's a metal on metal surface with no plastic. Years ago when it was metal against plastic, it had a very high failure rate in this country and I resisted doing this operation. I shied away from it for many years until, in 2008, I read an article from Australia about 20,000 patients who had hip resurfacing. What caught my attention was that these were not patients of just one doctor who might be getting payments from the implant company, but patients of multiple surgeons. Most importantly, the doctors were reporting a ten-year follow-up. The data they reported showed less than a 1% complication rate. (The complication rate for total hip implant surgery is 1-2%.) This information was so impressive to me and so different from what I had experienced over my twenty years of being an orthopedic surgeon, that I said, "It's time."

I flew to Canada to meet the surgeon from Birmingham, England, Ronan Treacy, who helped design the Birmingham hip implant and to learn to do the surgery. He has done over 4,000 Birmingham Hip Resurfacing (BHR) surgeries. I enjoyed meeting him, learning from him in cadaver labs and the operating room and finding out that we have the shared experience of him using my ultrasonic tools. Over the past two years, I have enjoyed doing this operation on men who are in their late 20s, 30s, and early 40s. I say "men" because complications are starting to be reported about women with this surgery because of their different bone density. With a higher chance of developing osteoporosis later in life, there's also a higher chance of a late (what does this mean?) femur fracture. Some surgeons are still doing them in women, but I worry about metal ions from the metal on metal surface in women of childbearing age and about the possibility of fractures later.

In the last two years, I have chosen carefully patients who are perfect candidates for the Birmingham Hip Resurfacing procedure. Each of these young men has been thrilled with the results. After their rehabilitation, I have allowed them to play basketball and tennis, to go surfing, and to do all activities without any reservations.

-Dr. Robert Klapper, M.D.

I have always been active and especially loved to play basketball. I played college ball and two years in the ABA with the San Diego Conquistators. When I was about 48, I began have hip symptoms - every time I stood after sitting for more than three minutes, it took me at least 30 seconds to stand fully straight and at the same time I would feel searing pain. I saw three orthopedic surgeons prior to meeting with Dr. Klapper. They all told me my basketball playing days were over and that I needed hip replacement surgery. I spent almost two years fighting the insurance system. After a lot of research online, I saw Dr. Klapper who told me about another option, the Birmingham Hip Resurfacing System. He said, "Once you have healed from surgery, there will be no restrictions on you. Just send me a picture of you playing basketball when it is all done!"

Dr. Klapper saved my life. I pretty much considered my life over since I wasn't going to be able to do what I like best.

I spent three days in the hospital, three days on two crutches, three days on one crutch, and one week using a cane. Two weeks after surgery I walked with no aid and without much of a limp. Four weeks after surgery, I walked with no limp - and no pain when getting up from a seated position!

-Craig Peters