Re-Cerf & ACL (Hip resurfacing) at young age

[Dario]

Hi everyone,

I'm 27 and would really value the collective experience here before I go further with my surgeon. I've attached my X-rays (standing pelvis + right hip).

My situation, short version:

- Right hip: The main thing I feel is a sense of *blockage* — like the ball doesn't always rotate cleanly in the socket. It's stiffness and a mechanical "catching" feeling more than pain; actual pain is rare. It's been there for about 6 - 8 years and has clearly gotten worse over the last 5. Oddly, my internal rotation feels fine but external rotation on the right is noticeably limited.

- Lower back: This is where I actually get daily discomfort, and real pain after sport. Never in the hip itself.

- Knee (same leg): I've had ACL and meniscus reconstruction. At rest I can't fully straighten it, but under load / when I push, it does straighten.

- What I want: to stay active — mainly running, cycling and swimming.

My surgeon has advised a ceramic hip resurfacing (the newer Re-Cerf).

My two real questions:

1. The "blocking" feeling.

Does anyone recognize this — a hip that feels like it doesn't turn freely in the socket, with limited external rotation but little pain? What did it turn out to be for you, and did resurfacing actually resolve that mechanical feeling?

2. The knee connection
Does anyone here have experience with a knee that no longer bends/straightens fully and naturally, *combined* with a hip replacement or resurfacing? My worry: if my leg doesn't move through a normal range because of the knee, does that altered gait put extra load on a new hip and shorten its lifespan? Has anyone been told anything about this by their surgeon, or lived it? At my age I'm very conscious that this hip has to last a ling time.

Any knowledge, stories, or "here's what I wish I'd asked" would mean a lot. Thanks in advance.

[Terry999]

I've had 2 resurfacings BHR 20 yrs ago and CoC H1 last year. I had first at 37 years 2nd at 57.
The  hips move naturally I forget I have implants. What could cause your blocking? What did the Surgeon say.

27 is really young to be having such surgery could you try to make the hip last longer - maybe reduce the running? Physio or other treatments.
At your age I would be thinking of revision. Say the implant lasts 20-25 years that means you'll be 47 or 52. I know it doesn't sound like it but that is still young for hip surgery.  Revisions last less than the original ops and people tend to be less happy with the outcomes of revisions.
The great thing about Resurfacing is you keep most of the femur so if it has to be revised to a THR it's like having it for the first time. Unlike a revision of femur in THR.
However Ceramic is Stiffer than Co-Cr (BHR resurfacing) which in turn is stiffer than Titanium, used in most THRs. Ceramic flexes less, transferring less load to the bone so over time the bone behind the Cup wastes away. Happens in all implants but may be worse with Ceramic. However the ceramic cup is smaller than BHR which is smaller than THR. So you're losing less pelvic bone in the first place with a CoC resurfacing. I hope this pushes it to my advantage

I think THR cups have fixing holes, these can be used to inject bone growth/graft  at revision. Resurfacing cups don't have these holes makes getting bone material behind cup very difficult.
So pros and cons to all of them.

I hope to get my BHR, when time comes revised  to a dual mobility THR, i.e. I can keep the existing cup.

If you do get a resurfacing you need an experienced surgeon.