Resurfacing

With the word Resurfacing a procedure and special line of hip prostheses is meant whereby resection of the femoral neck no longer is needed or the placement of a long stiff and intruding shaft in the femur as previously always had been the case with the traditional hip prostheses. Resurfacing or Hip Resurfacing seems a very logic name when you see the prosthesis that only places surfaces of metal in place for the damaged or worn cartilage. “Ytprotes” is one of the Swedish names for resurfacing, whereby “Yt” means “outer” or “surface” and “protes” means “prosthesis”. So “ytprotes” can be translated to “surface prosthesis”, which sounds correct. That the conventional hip prosthesis requires removal of the femoral neck and also removal of some or all of the marrow from the leg is not realized by everyone, so make sure that you understand the consequences of this. In Sweden the expression “Birmingham protes” or “Birminghamprotes” (translated: Birmingham prosthesis”) is sometimes incorrectly used for the whole group of hip resurfacing devices. That would be just as dumb as when you call every vacuumcleaner a “Hoover”. BHR stands for “Birmingham Hip Resurfacing” a prosthesis from one manufacturer (Smith & Nephew) just as for example BMHR stands for “Birmingham Mid-Head Resection”. Resurfacing is not incorrect but does not specifically clarify what it ‘resurfaces’. People should also know that there are resurfacing prostheses for the human hip but also the arm/shoulder joint. There are also similar resurfacing prostheses for animals in a variety of sizes.

“Ytersättning” is a Swedish term that translated is something like “outer replacement” or “surface replacement”. This does not clearly indicate if the method or the prosthesis is meant and in studies and writings on hip resurfacing this is also mixed.

Apart from sometimes confusing Swedish names for this type of prosthesis and the method have the English speaking countries created many more names and thereby much confusion. Not the least in the USA have surgeons for some reason found it necessary to invent fancy new names, as if they wanted to advertise a completly new and unique device and procedure that only they could offer their patients. With a different name no doubt extra attention is drawn and patients are given the impression that they secured themselves a modern and researching surgeon, while this does not necessarily have to be true. True is that it all the time is the exact same technique that Mr. Derek McMinn and others have further developed from earlier forms of hip resurfacing to what it is today.

All the names and abbreviations (taken from my list with terminology):

HR	Hip Resurfacing
HRS	Hip Resurfacing
HR	Hemi Resurfacing
HA	Hemi Arthroplasty
HSR	Hemi Surface Replacement
PR	Partial Resurfacing
THR	Total Hip Resurfacing
PHR	Partial Hip Resurfacing
HSR	Hip Surface Replacement
SHR	Surface Hip Replacement
HRA	Hip Resurfacing Arthroplasty
RHA	Resurfacing Hip Arthroplasty
MoMHR	Metal-on-Metal Hip Resurfacing
RTHA	Resurfacing Total Hip Arthroplasty
SRA	Surface Replacement Arthroplasty
THRA	Total Hip Resurfacing Arthroplasty
MMSR	Metal-on Metal Surface Replacement
MoMRA	Metal-on-Metal Resurfacing Arthroplasty
MoMHRA	Metal-on-Metal Hip Resurfacing Arthroplasty
MoMRHA	Metal-on-Metal Resurfacing Hip Arthroplasty
MoMTHRA	Metal-on-Metal Total Hip Resurfacing Arthroplasty

The three names above that include “hemi” apply to a form of hip resurfacing whereby the old natural femoral head is given a new surface “the cap” and whereby no acetabular cup is placed in the pelvis. This method that is also sometimes used in Sweden is under critisism and rightfully so! The idea to only replace the diseased outer surface of the femoral head is in itself not wrong but in real life it has been proven that the remaining cartilage in the acetabulum wears out at high speed. The cartilage and a metal head or cap are incompatible with each other with rapid wear as a result. It is therefore not unusual at all that someone with a “hemi resurfacing” needs to be operated again after a year or so to add the acetabular cup that matched the head that was placed a year ago. Real resurfacing specialists are in agreement that hemi resurfacing can not be suppoted or defended and that a complete hip resurfacing cap and matching cup should be placed right from the start, so that no new operation will be required for addition of the cup.