An alternative to total hip replacement in which the femoral head is capped rather than removed. Suitable for a carefully selected group of younger, active patients with end-stage hip arthritis.
(03) 9573 9659
Hip resurfacing is an alternative to total hip replacement in which the femoral head is shaped and capped with a metal component rather than removed entirely. It is appropriate for a carefully selected group of younger, active patients with end-stage hip arthritis. Patient selection is critical, and Mr Balakumar reserves resurfacing for cases where the specific anatomy and patient profile make it the most appropriate option after careful discussion.
In resurfacing, the damaged surface of the femoral head is prepared and fitted with a metal cap, while the acetabulum is fitted with a metal socket. Because the femoral head is preserved rather than removed, a larger bearing diameter is possible. This allows a greater range of motion and may reduce the risk of dislocation compared to some standard replacement designs.
Resurfacing uses a metal-on-metal bearing surface, which distinguishes it from Mr Balakumar’s standard hip replacement approach. He does not use metal-on-metal bearing surfaces routinely, and the decision to offer resurfacing is made only after a thorough assessment of the patient’s specific circumstances.
Resurfacing is most appropriate for younger, active males with good bone quality, end-stage hip arthritis and no significant femoral head deformity or metal hypersensitivity. It is not suitable for women of childbearing age due to concerns about metal ion exposure, patients with metal sensitivity, those with significant femoral head deformity, or patients with osteoporosis.
The metal-on-metal concerns that became well documented following widespread use in the early 2000s, including metal ion release, ALVAL reactions and pseudotumour formation, highlighted the importance of rigorous patient selection. Mr Balakumar does not offer resurfacing routinely.
In appropriately selected patients, resurfacing provides good functional outcomes and allows a high activity level. Long-term survivorship in carefully selected patients is good, though it does not match the data for modern uncemented total hip replacement implants. Risks specific to resurfacing include metal ion release, ALVAL, pseudotumour formation and femoral neck fracture, in addition to the general risks of any hip surgery. These are discussed in full at the consultation.
(03) 9573 9659
Mr Balakumar is one of a small number of surgeons in Australia with formal training in both paediatric and adult hip surgery. His fellowship at Harvard’s Children’s Hospital in Boston, under some of the world’s leading specialists in hip preservation, gives him a depth of expertise that is difficult to find in a single practice.
His approach is the same whether the patient is 6 months or 65 years old – thorough assessment, honest options, and no pressure toward surgery until the clinical picture clearly supports it.
(03) 9573 9659
A procedure in which the femur is cut and repositioned to correct abnormal alignment around the hip or knee. Used in both paediatric and adult patients as part of joint preservation surgery.
The gold standard surgical treatment for hip dysplasia in adolescents and adults with preserved joint cartilage. Mr Balakumar trained in this technically demanding procedure at Harvard’s Children’s Hospital Boston.
An open procedure allowing complete access to all surfaces of the hip joint. Used for complex conditions that cannot be adequately addressed through arthroscopy alone.
Keyhole surgery to treat impingement, labral tears and a range of other hip conditions. Mr Balakumar is fellowship trained in hip arthroscopy and performs labral repair and reconstruction as required.
Melbourne Orthopaedic Group is home to a team of experienced orthopaedic surgeons, providing comprehensive care for sports injuries and orthopaedic conditions. Whether it’s joint replacement or sports injuries, our specialists provide comprehensive orthopaedic care.
