Incredible Self Surgeries

[WARNING: This list contains some graphic images.] Self-surgery is the act of performing a surgical procedure on oneself. Sometimes it becomes necessity in extreme conditions to perform this act. This list includes 10 such individuals that because of great circumstances found it necessary to do so. It should be mentioned that self castration and self mutilation is actually the most common form of self- surgery and is not included in this list. Just a word of caution: The descriptions and some pictures on this list are not for the squeamish.

Dr Jerri Nielsen

Born 1952



Surgical Procedure: Biopsy

Dr. Jerri Lin Nielsen is an American physician with extensive ER experience. In 1998 she was hired to spend a year at the Amundsen-Scott South Pole Station where she would be the only doctor during the winter. In early March 1999, Dr. Jerri Nielsen discovered a lump in her right breast. After consulting US physicians via email and video conference she performed a biopsy upon herself. The results were inconclusive because the material used on site was too outdated to allow for a precise diagnosis. It was then decided to send a military plane to airdrop supplies and medication for her treatment. Using the new supplies, she performed another biopsy which allowed for better scans to be sent to the US, where it was confirmed that the cells were cancerous. With the help of her makeshift medical team, Nielsen then began self-administering chemotherapy. In October a military transport aircraft was sent several weeks ahead of schedule to bring her back home. Once back in the United States, after multiple surgeries, complications and a mastectomy Nielsen went into remission.

Interesting Fact: Nielson became a motivational speaker and wrote a book about her experience. The book (Ice Bound) was later adapted into a made-for-TV movie starring Susan Sarandon.


Amanda Feilding
Born 1943



Surgical Procedure: Trepanation

Amanda Feilding is a British artist and scientific director. Feilding suffered from a condition that left her feeling exhausted and spent years looking for a reputable surgeon who would perform a technique known as trepanning. This is a procedure where a tiny portion of the skull is drilled into to allow blood to flow more easily around the brain. Eventually she gave up and at age 27 she decided to do the surgery herself. She was equipped with a dentist’s electric drill operated by a foot pedal she then taped dark glasses to her face to stop the blood running into her eyes. She first made an incision with a scalpel and then drilled, dipping the drill bit in water every so often to cool it down. She lost almost a liter of blood but she was pleased with her surgery. Over the next four hours she noticed herself rising up with a feeling of elation and relaxation. Feilding says, “I went out and had steak for supper, and then I went to a party.”

Interesting Fact: Feilding made a short cult art film entitled ‘Heartbeat in the Brain’ and is shown only to invited audiences. She also ran for British Parliament twice, on the platform ‘Trepanation for the National Health’ with the intention of drawing attention to the fact that its potential benefits should be scientifically investigated.




Deborah Sampson
1760 - 1827



Surgical Procedure: Extraction of Musket Ball

Deborah Sampson was actually mentioned in the “Top 10 Men Who Were Really Women” list as a notable omission. In 1782 Deborah Sampson was enlisted in the Fourth Massachusetts Regiment of the Continental Army. Going by the name of Robert Shutleff she was strong and tall enough to look like a man and it was thought she didn’t have to shave because she was a very young man. When her unit was sent to West Point, New York she was wounded in a battle nearby. She was taken to a hospital to be treated but snuck out so that she would not be discovered to be a woman. She operated on herself and removed one of the musket balls out of her thigh with a penknife and sewing needle. When she recovered from her wound she went back to her regiment. The next time Sampson was wounded her doctor found out she was a woman and in 1783 he arranged for her to be discharged from the Continental Army.

Interesting Fact: Due to her wounds, Gannett received a military pension from the United States of America. Later, in 1838, Congress passed a special act granting a pension to her heirs.




Dr Evan O’Neill Kane
1862 - 1933



Surgical Procedure: Appendectomy and Inguinal Hernia Repair

Dr. Evan O’Neill Kane was a pioneer in the medical profession and chief surgeon of New York City’s Kane Summit Hospital. Kane wanted to prove to the world that general anesthesia was often unnecessary for minor operations. He used himself for a test case and operated on himself removing his own appendix using only local anesthetic. Dr. Kane propped himself up on the operating table with a mirror over his abdomen and three other doctors in the operating room as backup. Kane made the large incision needed to remove the appendix and his assistants sutured him up. (This was before new techniques allowed doctors to make small ‘Band-Aid’-size incisions for appendix removal). Then, in 1932, at age 70, Dr. Kane performed an even more complicated surgery on himself to repair an inguinal hernia. Because of the close proximity to the femoral artery it was a particularly delicate operation which Kane performed it in just under two hours.

Interesting Fact: The photo above is from his hernia repair and when performing the surgery Kane was very relaxed and even joking as he came within millimeters of important blood vessels.




Joannes Lethaeus
Born circa 1620



Surgical Procedure: Lithotomy (Removal of stones formed inside certain hollow organs such as the bladder and kidneys)

This self surgery occurred over 360 years ago. Dr. Nicolaes Tulp was a Dutch surgeon and mayor of Amsterdam. Below is the exact text from his book “Observationes medicae” In this case he describes Joannes Lethaeus who was a blacksmith who performed Lithotomy surgery on himself. The illustration above is also from Dr. Tulp’s book and displays the stone that Lethaeus removed from his own kidney and the knife that he used.

Having decided that no one but himself would cut into his flesh, he sent his wife to the fish market, which she didn’t mind doing. Only letting his brother help him, he instructed him to pull aside his scrotum while he grabbed the stone in his left hand and cut bravely in the perineum with a knife he had secretly prepared, and by standing again and again managed to make the wound long enough to allow the stone to pass. To get the stone out was more difficult, and he had to stick two fingers into the wound on either side to remove it with leveraged force, and it finally popped out of hiding with an explosive noise and tearing of the bladder. Now the more courageous than careful operation was completed, and the enemy that had declared war on him was safely on the ground, he sent for a healer who sewed up the two sides of the wound together, and the opening that he had cut himself, and properly bound it up; the flesh of which grew so happily that there no small hope of health was, but the wound was too big, and the bladder too torn, not to have ulcers forming. But this stone weighing 4 ounces and the size of a hen’s egg was a wonder how it came out with the help of one hand, without the proper tools, and then from the patient himself, whose greatest help was courage and impatience embedded in a truly impenetrable faith which caused a brave deed as none other.

Interesting Fact: There is an oil painting by Rembrandt called “The Anatomy Lesson of Dr. Nicolaes Tulp” and shows Dr. Nicolaes Tulp (who wrote the above text) explaining the musculature of the arm to medical professionals and is housed in the Mauritshuis museum in The Hague, the Netherlands.




Dr Leonid Rogozov
Born 1937



Surgical Procedure: Appendectomy

At the age of 27 Soviet Doctor Leonid Rogozovwas was stationed at the Novolazarevskaya base in the Antarctic. The doctor recognized his own acute appendicitis and worsening condition. Because of the absence of a support aircraft and inclement weather along with the danger of a burst appendix the doctor decided he would have to perform surgery on himself. With the team’s meteorologist holding the retractors, a driver to hold the mirror and other scientists passing surgical implements, he sat in a reclined position and cut out his own appendix under local anesthetic. During the operation he passed out, but was able to continue and complete the procedure in little less than two hours.

Interesting Fact: A detailed report was written by Dr Rogozov documenting the unusual event along with the photo shown above. The doctor made a full recovery and resumed all duties in two weeks.


Surgical Procedure: Amputation of Right Arm

In September of 2007 Parker a Farmer from South Carolina was harvesting corn when some stalks got stuck in a set of rollers that shuck the cut corn. He reached in the still-running machine to pull the stalks out and the rollers grabbed first his glove and then his hand. Parker tried yelling for help, but there was no one near the isolated field in Kershaw County. For more than an hour, he tried to pull his hand free, only to have it pulled ever further into the machinery. He was able to reach an iron bar and jam it into a chain-and-sprocket that drove the rollers, and, with his fingers growing numb he pulled out a small pocketknife and started to cut his own fingers off to free himself. Before he could do that the sprocket grinding against the rod he’d jammed in it threw off sparks and set the ground litter on fire. Parker then knew he had to cut his arm off or die right there. Parker credits the fire with keeping him from passing out from the shock of cutting through his arm. When he got down to the bone, he dropped onto the ground, using the force of his own weight to break the bone and free him from the machine. When he was finally loose he got in his pickup truck and started driving his truck into the middle of the road to force a car to stop. Finally a motorist stopped and a rescue helicopter was called in to take him to a hospital. Parker spent three weeks in a burn center before going home.

Interesting Fact: While he was recuperating, about 25 of his neighbors got together to finish harvesting his corn,


Douglas Goodale
Born 1965



Surgical Procedure: Amputation of Right Arm

In 1998 Douglas Goodale a 35 year old lobster fisherman from Maine was hauling lobster pots up from the sea floor. When he reached his first trap and started pulling up his catch a huge wave hit the boat creating a slack in the rope which then spooled around the drum. As he reached to turn off the drums motor and untangle the rope his sleeve got caught in the winch. Within seconds the winch had taken hold of his hand and his arm. Alone and unable to free himself and his body hanging outside the boat, the fisherman’s survival instincts took over and used his good arm to pull his body back into the boat. Because of the way his right arm was twisted he had to dislocate the shoulder joint of his injured arm in the process. The only way for Goodale to free himself was to cut off his own arm. Thinking about his wife and two daughters, Goodale grabbed his twine knife and began to saw off his right arm. The cold ocean water and the twisting had cinched up the wounds and helped to reduce blood loss. Goodale then managed to pilot his boat back into the harbor to get medical help.

Interesting Fact: Having only one arm has not kept Goodale from two seasons of lobstering and from completely overhauling his 35’ wooden boat down to the bare planks. Goodale was also featured in the television show “Extreme Makeover: Home Edition” where 1,000 volunteers Goodale’s double-wide mobile home with a $500,000 log home.





Ines Ramírez
Born 1960



Surgical Procedure: Caesarean Section

Ramírez Pérez lives in rural Rio Talea Mexico which has 500 people and only one phone. In March of 2000 the 40-year-old mother of seven was alone in her cabin when her labor started. She assumed her birthing position by sitting up and leaning forward. At midnight after 12 hours of continual pain and little advancement in labor and rather than experience another fetal death that occurred from her last pregnancy Ramírez decided to operate on herself. She drank from either a bottle of rubbing alcohol or 3 small glasses of hard liquor” (different accounts vary). She then grabbed a 15-cm knife and began to cut. Ramirez sawed through skin, fat and muscle and after operating on herself for an hour she reached inside her uterus and pulled out her baby boy who breathed and cried immediately. She says she cut his umbilical cord with a pair of scissors and then passed out. When she regained consciousness she wrapped clothes around her bleeding abdomen and asked her 6-year-old son to run for help. Several hours later the village health assistant found Ramírez alert and lying beside her healthy baby. She was then taken to the nearest hospital eight hours away by car and underwent surgery to repair complications resulting from damage to her intestines incurred during her C-section. She was then released from the hospital and made a complete recovery.

Interesting Fact: Ramírez is believed to be the only woman known to have performed a successful caesarean section on herself. Her case was written up in the March 2004 issue of the International Journal of Obstetrics and Gynecology.

Surgical Procedure: Amputation of Right Arm

Aron Ralston’s experience made international news so many will be familiar with his story. Ralston is an American mountain climber and a mechanical engineer. He left his career in engineering to climb all of Colorado’s “fourteeners”, or peaks over 14,000 feet high. In 2002 while he was on a canyoneering trip alone in Blue John Canyon a boulder fell and pinned his right forearm. After five days of unsuccessfully trying to lift or break the boulder, a dehydrated and delirious Ralston prepared to cut off his already dead arm. Using a dull blade he cut the soft tissue around the break and then used the tool’s pliers to tear at the tougher tendons. Finally freed, Ralston was still 8 miles from his truck he had to rappel down a 65-ft cliff, then hike out of the canyon. Eventually he met with other hikers and was given food and water. Aron was finally transported to St. Mary’s Hospital in Grand Junction Colorado for surgery.

Interesting Fact: Later Ralston’s arm was retrieved by park authorities and removed from under the boulder. It was cremated and given to Ralston. He later returned to the boulder and left the ashes there. Aron Ralston still enjoys mountain climbing with the aid of a prosthetic arm.

About Lasik Complications

Some people who undergo LASIK surgery have experienced some kind of complication . However, if you have an experienced surgeon by your side, the rate of surgical complications is far reduced. Common sense aside, one should base their decisions on the actual facts reported by their treatment provider. Overall, the number of complications are generally reported to be less than 1%. Most of the reported problems are handled through laser re-treatments or enhancements.

In order to understand the kind of complications people have your should understand what a LASIK treatment is all about. During LASIK surgery a laser beam is used to cut a very thin, hinged flap into the front of the eye. The flap is then lifted and the laser is applied to re-shape the eye, and then the flap is replaced to heal.

Some of the more common types of LASIK complications are improperly formed LASIK flaps: Sometimes after the first surgery a patient might experience an improperly formed flap. This might create an irregular surface and cause various vision defects. In such cases, LASIK surgery needs to be repeated one or more times to make the eye surface smooth.

Inflammation: Sometimes there might be inflammation that can develop in areas where the flap comes in contact with the eye. Such a condition, is called diffuse lamellar keratitis (DLK). It may create symptoms such as sensitivity towards light and loss of Vision .

Epithelial In growth: If there is any kind of initial swelling in the eye it might create a common LASIK complication called Epithelial in growth, This condition can be best described as a type of scarring which leads to an irregular eye surface and other vision distortions. In such a condition the surgeon lifts the flap and scrapes out the epithelial growth from inside. This is certainly not a full proof method. It has been noticed that in many cases the epithelial in growth reoccurs.

Some other common types of LASIK complications include dry eye, infections and night vision problems such as glaring around the lights.

Many trained surgeons feel that by using better technology and more precise instruments the chances of having a major LASIK complication can be avoided. People who have had a history of eye complications or infections are not advised to go for these surgeries.

A New Direction In Weight Control - Gastric Bypass Surgery

Surgery may be a weight-loss option for patients who are severely obese and suffer from serious medical complications due to weight. There are two accepted surgical procedures for reducing body weight: gastroplasty and gastric bypass. Although these two procedures use different surgical methods, they both reduce the stomach to a pouch that is smaller than a chicken’s egg, drastically limiting the amount of food that can be consumed at one time. Surgery produces 25 to 35 percent reductions in weight over the first year and most of this weight loss is maintained five years after surgery. More importantly, the serious medical conditions that accompany extreme obesity improve significantly. Surgery is not without risk and should be performed by skilled surgeons who also provide patients with a comprehensive program for long-term weight control.

Limited gastric capacity and a narrow anastomotic gastrointestinal stoma necessitate certain dietary modifications particularly in the early post-operative period. Diet progression varies amongst health care professionals. A standardized GBP diet does not exist. Generally, most patients begin with a liquid diet due to the small, edematous gastric outlet. This phase of the diet may range from one day up to 6 weeks. Afterwards, pureed textures are introduced and the diet is slowly advanced to soft-textured foods by about 12 weeks. Small, frequent meals rich in protein are emphasized. Liquids are usually consumed between meals to allow greater intake of calories and protein with solid foods. Carbonated drinks may cause distension and discomfort from the carbon dioxide. Red meats, tough meats, breads and milk products may be difficult for some patients to tolerate. Until solid food intake is adequate, high protein liquid supplements such as sugar free Carnation Instant Breakfast (mixed with low lactose milk if necessary) are often recommended.

During the first six to 12 months after surgery, patients generally consume 900 to 1000 calories. Calorie consumption slowly increases due to a change in the pouch size and stoma size, gastric emptying rate and intake of solid food. Sugar and concentrated sweets are discouraged in order to prevent dumping syndrome. Because the pyloric sphincter is bypassed, simple sugar is dumped into the small intestine causing an increase in the osmotic load, thereby drawing fluid into the intestine leading to diarrhea, nausea, diaphoresis and abdominal cramps. The shunting of blood to the intestines and the perceived decrease in blood volume 30 minutes to one hour after a meal prompts many patients to lie down in an effort to improve cardiac output.

Gastric bypass patients generally lose 50%–75% of excess body weight and are usually successful with weight maintenance.

The obese population, especially the morbidly obese, is increasing at an alarming rate in the United States. Weight loss programs have been found ineffective in this group. In an effort to improve the quality of life and decrease comorbidities associated with this patient population, gastric bypass surgery may be an option.

A Cure for Near Sightedness - Radial Keratotomy

Radial keratotomy (RK) is a refractive surgical procedure employed to correct myopia or nearsightedness. Radial Keratotomy came into existence by accident rather than through meticulous research. The procedure was discovered by Dr. Svyatoslav Fyodorov when he operated one of his patients who had met with a bicycle accident. The boy wore eyeglasses, which broke on impact, and the glass splinters lodged into his eyes. The doctor had to make several radial incisions in the corneal tissue in order to extract the glass. When the cornea healed, the doctor found that the boy’s eyesight was significantly improved.

In radial keratotomy (RK), a series of micro-fine incisions are made in the outer portion of the cornea with the aid of a high-precision calibrated diamond knife. The surgeon administers a local anesthetic, since the incisions are superficial and the procedure is fairly painless. The corneal thickness of the patient’s eye is measured prior to the surgery. Before the incisions are made, the diamond-edged cutting instrument is precisely set under the operating microscope. Thus by flattening the curvature of the cornea in such a manner, RK can easily correct myopia or nearsightedness.

Radial keratotomy was first introduced in the United States in the 1980s. Initially it was much of an investigational procedure, with doctors operating only one eye at a time and waiting for at least 3 months to observe the results, before operating on the other eye. But the surgeons gained experience over time and now they could well operate both eyes simultaneously. Now, radial keratotomy is a minor surgery that takes about 15 to 20 minutes for each eye.

Radial keratotomy is constantly improving, owing much to the rapid advances in technology, and the fact that a number of such procedures have already been performed successfully. However, RK is not as precise as LASIK and PRK. Since, RK is less predictable, only a few surgeons now perform this procedure.

A Brief Ovierview Of Lasik Eye Surgery

LASIK, an acronym for Laser-assisted In Situ Keratomileusis, is a form of refractive laser eye surgery procedure performed by ophthalmologists intended for correcting vision. The procedure is usually a preferred alternative to photorefractive keratectomy, PRK, as it requires less time for full recovery, and the patient experiences less pain overall.

The LASIK technique was made possible by Dr Jose Barraquer (Colombia), who around 1960 developed the first microkeratome, used to cut thin flaps in the cornea and alter its shape, in a procedure called keratomileusis. This procedure was developed and pioneered by the world leading Barraquer Clinic, based in Bogota, Colombia.

LASIK surgery was developed in 1990 by Dr. Lucio Buratto (Italy) and Dr. Ioannis Pallikaris (Greece) as a melding of two prior techniques, keratomileusis and photorefractive keratectomy. It quickly became popular because of its greater precision and lower frequency of complications in comparison with these former two techniques.

In 1991, LASIK was performed for the first time in the United States by Drs. Stephen Brint and Stephen Slade. The same year, Drs. Thomas and Tobias Neuhann successfully treated the first German LASIK patients with an automated microkeratome.

Patients wearing soft contact lenses typically are instructed to stop wearing them approximately 7 to 10 days before surgery. One industry body recommends that patients wearing hard contact lenses should stop wearing them for a minimum of six weeks plus another six weeks for every three years the hard contacts had been worn.

Before the surgery, the surfaces of the patient's corneas are examined with a computer-controlled scanning device to determine their exact shape. Using low-power lasers, it creates a topographic map of the cornea.

This process also detects astigmatism and other irregularities in the shape of the cornea. Using this information, the surgeon calculates the amount and locations of corneal tissue to be removed during the operation. The patient typically is prescribed an antibiotic to start taking beforehand, to minimize the risk of infection after the procedure.

The operation is performed with the patient awake and mobile; however, the patient typically is given a mild sedative (such as Valium or diazepam) and anesthetic eye drops.

Lasik is performed in two steps. The initial step is to create a flap of corneal tissue. This process is achieved with a mechanical microkeratome using a metal blade, or a femtosecond laser microkeratome that creates a series of tiny closely arranged bubbles within the cornea. A hinge is left at one end of this flap. The flap is folded back, revealing the stroma, the middle section of the cornea. The process of lifting and folding back the flap can be uncomfortable.

The second step of the procedure is to use an excimer laser (193 nm) to remodel the corneal stroma. The laser vaporizes tissue in a finely controlled manner without damaging adjacent stroma by releasing the molecular bonds that hold the cells together. No burning with heat or actual cutting is required to ablate the tissue. The layers of tissue removed are tens of micrometers thick.

During the second step, the patient's vision will become very blurry once the flap is lifted. He or she will be able to see only white light surrounding the orange light of the laser. This can be disorienting.

Currently manufactured excimer lasers use a computer system that tracks the patient's eye position up to 4,000 times per second, redirecting laser pulses for precise placement. After the laser has reshaped the cornea, the Lasik flap is repositioned over the treatment area by the surgeon. The flap remains in position by natural adhesion until healing is completed.

Performing the laser ablation in the deeper corneal stroma typically provides for more rapid visual recovery and less pain.

A Brief History Of Hip Replacement Surgery

Hip replacement is a medical procedure in which the hip joint is replaced by a synthetic implant. It is the most successful, cheapest and safest form of joint replacement surgery. The earliest recorded attempts at hip replacement, which were carried out in Germany, used ivory to replace the femoral head.
Use of artificial hips became more widespread in the 1930s; the artificial joints were made of steel or chrome. They were considered to be better than arthritis but had a number of drawbacks. The main problem was that the articulating surfaces could not be lubricated by the body, leading to wear and loosening and hence the need to replace the joint again (known as revision operations).

Attempts to use teflon produced joints that caused osteolysis and wore out within two years. Another significant problem was infection. Before the advent of antibiotics, surgery on the joints carried a high risk of infection. Even with antibiotic treatments, infection is still a cause for some revision operations. Such infections are not necessarily caused at surgery; they can also be the result of bacteria entering the bloodstream during dental treatment.

The modern artificial joint owes much to the work of John Charnley at the Manchester Royal Infirmary; his work in the field of tribology resulted in a design that completely replaced the other designs by the 1970s. Charnley's design consisted of 3 parts – (1) a metal (originally Stainless Steel) femoral component, (2) an Ultra high molecular weight polyethylene acetabular component, both of which were fixed to the bone using (3) special bone cement. The replacement joint, which was known as the Low Friction Arthroplasty, was lubricated with synovial fluid.

The small femoral head (22.25mm) produced wear issues which made it suitable only for sedentary patients, but - on the plus side - a huge reduction in resulting friction led to excellent clinical results. For over two decades, the Charnley Low Friction Arthroplasty design was the most used system in the world, far surpassing the other available options (like McKee and Ring).

In 1960 a Burmese orthopaedic surgeon, Dr. San Baw (29 June 1922 – 7 December 1984), pioneered the use of ivory hip prostheses to replace ununited fractures of the neck of femur ('hip bones'), when he first used an ivory prosthesis to replace the fractured hip bone of an 83 year old Burmese Buddhist nun, Daw Punya. This was done while Dr San Baw was the chief of orthopeadic surgery at Mandalay General Hospital in Manadalay, Burma. Dr San Baw used over 300 ivory hip replacements from the 1960s to 1980s.

He presented a paper entitled 'Ivory hip replacements for ununited fractures of the neck of femur' at the conference of the British Orthopeadic Association held in London in September 1969. An 88% success rate was discerned in that Dr San Baw's patients ranging from the ages of 24 to 87 were able to walk, squat, ride the bicycle and play football a few weeks after their fractured hip bones were replaced with ivory prostheses. Dr San Baw's use of ivory was, at least in Burma during the 1960s, 1970s and 1980s (before the illicit ivory trade became rampant starting around the early 1990s) cheaper than metal. Moreover, due to the physical, mechanical, chemical, and biological qualities of ivory, it was found that there was a better 'biological bonding' of ivory with the human tissues nearby the ivory prostheses. An extract from Dr San Baw's paper, which he presented at the British Orthopeadic Association's Conference in 1969, is published in Journal of Bone and Joint Surgery (British edition), February 1970.

In the last decade, several evolutionary improvements have been made in the total hip replacement procedure and prosthesis. Many hip implants are made of a ceramic material rather than polyethylene, which some research indicates dramatically reduces joint wear. Metal-on-metal implants are also gaining popularity. Some implants are joined without cement; the prosthesis is given a porous texture into which bone grows. This has been shown to reduce the need for revision of the acetabular component. Surgeons still frequently use bone cement for the femoral component, however, which has proven very successful after 35 years of clinical experience.

The latest developments are several competing Minimally Invasive Surgery (MIS) approaches, which may result in far less soft tissue damage and a quicker recovery. C.A.O.S (Computer assisted orthopedic surgery) is also being marketed heavily by the implant manufacturers, though its value remains largely unproven.. Computer assisted surgery is said to better navigate prosthetic implantation.

An alternative to total hip replacement (THR) is hip surface replacement (HSR), also referred to as hip resurfacing. With both THR and HSR, a prosthetic socket is pressed into the pelvis. With THR, the end of the femur is amputated, a metal shank is inserted into the femur, and the shank holds a ball which mates with the socket. With resurfacing, the end of the femur is not amputated; the outer surface of the femoral ball is replaced with a cylindrical metal cap. Resurfacing eliminates the common THR problem of the metal shaft loosening from the femur. Resurfacing preserves bone stock if a revision is ever needed. A larger diameter ball and socket more closely mimic the natural joint structure, reducing the risk of dislocation and improving range of motion. There has been no published clinical evidence to show that today’s CoCr metal-on-metal articulating surfaces have the osteolytic effect on bone that earlier polyethylene devices had. Ten year success rates of hip resurfacing from studies in England report success equal to or greater than standard total hip replacement, in age-matched patients. In the United States, the first modern resurfacing device received FDA approval in May 2006, while some 90,000 resurfacings have been performed world-wide.

Patients need to be aware of all surgical options before hip replacement surgery. Hip surgeons have different surgical techniques and surgical outcomes. Currently, there are several different incisions used to access your hip joint. The posterior approach (widely used by the majority of orthopedic surgeons) separates the gluteus maximus muscle in line with the muscle fibers to access the hip joint. Other methods access the hip from the lateral side of the hip joint. In contrast to the posterior approach and lateral approach, the anterior approach uses a natural interval between soft tissue to gain access to the hip joint. Its main disadvantages are that it risks damage to the lateral femoral cutaneous nerve, and it is not widely available to the public because fewer surgeons have been trained in this technique.