How easy is it to replace a resurfaced MOM/COC once they wear?

[Hippyu]

If you can get 20 years out of a resurfacing that is tremendous ad the alternate would be a THR which would cut your femur. At least with a resurfacing you always have the option generally for a "fresh" THR.

However, for those in their 30s we would want the option to have 1 resurfacing.... then 1 revised resurfacing adn then when aged the option for  THR.

How successful are revision resurfacings? Do much complications arise? I assume not it seems much easier to replace than a THR.

[imgetinold]

Hey, Hippyu,


Where did you come across the notion that you can revise a resurfacing with another resurfacing?  I have heard of situations where they were able to save the implant on the femoral head and revise only the acetabular cup, but that's typically when there is a problem with the cup and not the femoral implant.  If the femoral implant is worn, I don't think it can be revised.  If it was cemented on, how would you get it off?  If it was a bone-ingrowth femoral component (like Dr. Gross uses), how also would you get it off?


So, I question the original premise of your question.  I do NOT think it is possible to get a revised resurfacing, with the exception of an acetabular cup revision in certain circumstances.  If you have information to the contrary, please share links.

[catfriend]

Ask and ye shall receive: https://www.seattlejointsurgeon.com/system/resources/W1siZiIsIjIwMTkvMDYvMjEvMTUvNDEvMzYvNDZhOTdmMzItZDU2MC00NjBkLWJjOTktMWM1NDUyOWZhNzgxL3JldmlzaW9uLWhpcC1yZXN1cmZhY2luZy5wZGYiXV0/revision-hip-resurfacing.pdf

Dr. Pritchett does revised resurface to resurface surgeries. Saddlepal had a resurfacing revision by Dr. P. She has written about that elsewhere on this site. Each is unique, and they might not work for everyone, but they are a possibility.

[Saddlepal3]

Yes, I had a revision in 2018, but Dr. Pritchett only replaced the cup. It went really well.

[imgetinold]

Ask and ye shall receive: https://www.seattlejointsurgeon.com/system/resources/W1siZiIsIjIwMTkvMDYvMjEvMTUvNDEvMzYvNDZhOTdmMzItZDU2MC00NjBkLWJjOTktMWM1NDUyOWZhNzgxL3JldmlzaW9uLWhpcC1yZXN1cmZhY2luZy5wZGYiXV0/revision-hip-resurfacing.pdf

Dr. Pritchett does revised resurface to resurface surgeries. Saddlepal had a resurfacing revision by Dr. P. She has written about that elsewhere on this site. Each is unique, and they might not work for everyone, but they are a possibility.

Either this is exactly what I said, or I'm not understanding what a "stem-supported femoral prosthesis" is.  That sounds like a THR to me.  Unless a "stem-supported femoral prosthesis" is somewhere between a resurfacing and THR.  Then, what is a "long-stem femoral prosthesis"? 


I guess I got me some learnin' to do......


Andy

[LDub]

I believe you are right Imgetinold. Based on that paper (a very interesting read) the femoral head can't be revised in the same way the acetabular cup can.

Dr. Prittchard states in the paper:

There are favorable reports of converting the resurfacing procedure to a metal-on-metal  total hip replacement when there has been a femoral failure after hip resurfacing. This is not recommended, as there is too great a potential for cumulative collection of cobalt to occur in the tissues from the combined contribution from the bearing surface wear and trunnion (capture point of the femoral head on the stem).

I think the distinction is that he is not replacing the existing prosthetic with an actual THA prosthetic. In the case of the femoral head revision he uses a dual mobility prosthesis. To my untrained eye it looks like a THA prosthetic. But it is not.

This is an interesting and informative read. And it demonstrates the legs ;) you have when you choose hip resurfacing :).

Cheers,
LDub.

[Saddlepal3]

I believe that Dr. Pritchett sometimes will use a femural resurfacing component that has a stem of varying lengths. This is different from a THR component that is typically thicker. If you look at the images in his article, the stems are very narrow.