http://www.midmedtec.co.uk/hipresurface.html http://www.jri-oh.com/Types.htm http://www.jri-oh.com/Surface.htm
I am curious what position your patient was in when he dislocated? The hip is prone to this until between 3 and 6 months post op. I recall one patient who bent over and crawled under the kitchen sink looking for a whisky bottle....yep she dislocated. Another man was climbing a ladder 2 rungs at a time....yep him too.
The type of resurfacing device I am most familiar with is the Birmingham metal cup.
In hip resurfacing you are usually talking about using a metal cup that just covers the area that thefemoral head occupies. The are usually fixed through the trochanter. When hip surgery is done the hip is taken into a "position of disarticulation" that is the position they use to "pop out" the femoral head. That position is what they need to AVOID...as it will surely dislocate. It will depend on whether the surgeon uses an anterior incision (no high chairs, no leaning backward) or a posterior approach (no LOW chairs,toilet seats, no ad-duction of the legs)..I KNOW, I know, but we ortho nurses say it that way- A.D.duction and A.B.duction to make it plain)
After the THA or resurfacing, the hip is then rearticulated. The resurfacing is mainly to preserve the shaft and inside of the femur until absolutely a total hip is needed..that is... one that has a femoral component that is driven into the femoral canal.
Younger people would be the ones for resurfacing and that should provide them with a useable hip for quite awhile but not forever. Unfortunately most THAs have a limited lifespan.
The trouble that a THA revision gets into is removing the prosthesis. Preserving as much bone as possible is hard because of the femoral damage of removal.
Oh and I would treat them JUST like a total.
[ June 10, 2001: Message edited by: P_RN ]