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When someone is struggling with hip pain or osteoarthritis of the hip, the constant pain can be debilitating. Not only is the pain profound, but it can take away a person's freedom. When a person's quality of life suffers enough, hip replacements can reduce this joint paint and increase mobility.

"Studies show that hip replacements can significantly relieve pain, increase mobility and ultimately be a life-changing procedure," said Harry W. Schmaltz, M.D., an orthopedic surgeon at Geisinger-Community Medical Center, Scranton.

But once it's been determined by you and your doctor that your condition can be improved by hip replacement, your decision making isn't quite over yet. You and your physician also need to decide whether you should pursue total hip replacement surgery or hip resurfacing.

"Total hip replacement and hip resurfacing are both a type of hip replacement, but they have significant differences," Dr. Schmaltz said.

Traditional total hip replacement involves a doctor surgically removing a painful and arthritic hip joint and replacing it with an artificial joint, which is typically made from metal and plastic components.

"Total hip replacement is usually performed on a patient when all other treatment options have failed to provide pain relief," said Dr. Schmaltz. "In traditional total hip replacement, the head of the thigh bone, also referred to as the femoral head, and the damaged socket are both removed and replaced."

This is not quite the same with hip resurfacing.

"With hip resurfacing, the head of the thigh bone is not removed. Instead, it is trimmed and capped with a smooth metal covering. Just as in a traditional total hip replacement, the damaged bone and cartilage within the socket are removed and replaced with a metal shell," Dr. Schmaltz explained.

How do you determine which procedure is right for you?

Each has its advantages and disadvantages.

"Hip resurfacing may be easier to revise than a total hip replacement should the implant component wear out or loosen over time. Less bone is removed from the thighbone with hip resurfacing than traditional total hip replacement, which may make it easier to replace the femoral implant, but the cup side is no different, and maybe slightly more difficult" Dr. Schmaltz said.

With a traditional total hip replacement, it isn't possible to fracture the thighbone at the femoral neck since this portion of the joint is removed during the surgery. There is, however, a risk of this happening with hip resurfacings.

"There is a risk of harmful metal ions in a hip resurfacing patient's bloodstream. That's due to a metal ball moving within a metal socket in the hip - over time, as these metal surfaces rub together, there is a risk for wear and the release of metal ions. Low levels of metal ions aren't usually problematic, but high levels can be," explained Dr. Schmaltz.

And, in general, hip resurfacing is a more difficult operation than total hip replacement for surgeons to perform. They typically need to make a larger incision for hip resurfacings.

Given the advantages and disadvantages of hip resurfacing, it isn't a procedure for every patient to consider.

"The best candidates for a hip resurfacing procedure are younger with a larger frame and strong, healthy bones. Any other patients, particularly older, typically female, smaller-framed with weaker or damaged bones have a higher risk of complications," Dr. Schmaltz advised.

The best way to decide which procedure is right for you is to have a comprehensive exam by an orthopedic surgeon.