The latest on hip resurfacing: age and gender influence the success of this technique.(BONES & JOINTS)

Total hip replacement (THR) is one of the biggest success stories of modern medicine, with about 300,000 Americans undergoing the procedure annually. But a newer technique, called hip resurfacing, looks like the fastest-growing innovation in joint replacement in the near future. The procedure, available in Europe for more than a decade, was only approved by the Food and Drug Administration in 2008. It offers as many short-term benefits as hip replacement, costs about the same, and is usually covered by insurance. However, although it offers a bone-preserving alternative to THR, it may not suit everyone.

INTERIM SOLUTION. The fact that artificial hip joints typically start to wear out in 15 to 20 years, combined with increased longevity, means that many older adults face the prospect of complicated revision surgery a couple of decades after THR. This is where hip resurfacing comes in. "It has certain advantages over the conventional THR," says Craig Della Valle, MD, a specialist in joint reconstruction at Rush University Medical Center. "It preserves more bone because the head of the femur is retained. Some studies have also shown that it carries a lower risk of dislocation because the size of the ball component is larger." The fact that more bone is preserved means that THR is an option later, with the result that many patients and doctors are seizing on hip resurfacing as an interim solution that can tide patients over, enabling them to put off THR for as long as possible.

DRAWBACKS. A study led by Dr. Della Valle and published in the January 2009 issue of the journal Clinical Orthopedics and Related Research suggests that age and gender are key to the success of hip resurfacing. It reviewed 537 hip resurfacing surgeries performed in the U.S., and found that serious ...