Hip Resurfacing :

• Primary Osteoarthritis
• Posttraumatic Osteoarthritis
• Secondary Osteoarthritis
• Avascular necrosis of the femoral head if remaining bone stock is adequate
• Inflammatory arthritis if bone quality is adequate
• Patients with a deformity of the femur and/or internal fixation device that would make insertion of a stemmed femoral component difficult
• Patients with a high risk of dislocation

• Patients with the following indications are NOT suitable for hip resurfacing.
• Active Infection
• Malignant Tumours
• Insufficient acetabular or femoral bone stock
• Poor bone quality (for example, osteoporosis, osteomalacia)
• Anticipated non-compliance of the patient, alcohol or drug abuse
• Decompensated renal insufficiency
• Known allergy to one of the constituents of the implant

• Femoral head is preserved.
• Femoral canal is preserved and no associated femoral bone loss with future revision.
• Also, the risk of microfracture of femur with un cemented stem implantation is eliminated.
• Larger size of implant "ball" reduces the risk of dislocation significantly.
• Stress is transferred in a natural way along the femoral canal and through the head and neck of the femur. With the standard THR, some patients experience thigh pain as the bone has to respond and reform to less natural stress loading.
• Use of metal rather than plastic reduces osteolysis and associated early loosening risk.
• Use of metal has low wear rate with expected long implant lifetime.

• Be realistic. A stay in a tropical location may sound alluring, but could you get the same treatment or better nearer home?
• Work out the travel costs. India has fantastic medical centre's but it is a nine-hour flight away.
• Think of the cost of taking a companion along to accompany you too.
• Think of the physical implications of the journey —a day in economy class is a long time when you are recovering from an operation. Business class is comfier but much more expensive.
• Stay in constant touch with the medical facility you have chosen. Ask which physician will be performing the operation, how many he has done before.
• Ask what kind of post-operative support the facility has.
• Ask what arrangements are made for transfers between the airport and the medical centre on arrival and departure.
• What arrangements are made for your carer?
• Ask for testimonials of patients who have undergone procedures at the medical facility. Contact the people personally.

• Those with a degenerative bone disease such as AVN or arthritis
• The prosthesis may be constructed of various materials but is usually made of forged steel rather than cast steel (these were prone to break). The exterior of the unit is rough and porous so that the unit when press fitted with combine with the bone, which actually grows into the unit. This creates an immensely strong bond, which is hard to separate (rather like barnacles on a ship).