What is Hip Resurfacing? The "Andy Murray Hip".

As Wimbledon captures the attention of tennis enthusiasts worldwide, it's worth exploring the fascinating world of hip resurfacing and its association with the renowned tennis player, Andy Murray. The hip joint, a complex structure that allows for smooth movement and stability, can be prone to degeneration, especially in athletes engaged in impact sports like tennis. This article delves into the intricacies of hip degeneration, the challenges faced by Andy Murray due to hip injuries, and the transformative potential of hip resurfacing surgery as an alternative to conventional total hip replacement (THR). We also highlight the advantages and considerations of this procedure, shedding light on the possibilities it offers for individuals seeking relief from hip pain and a return to an active lifestyle.

The Anatomy of The Hip

The hip joint is formed by the articulation between the femur (the thigh bone) and the acetabulum of the pelvis.

It is a ball and socket (synovial) joint which is deepened by the labrum (a fibrocartilaginous structure) to allow greater stability, the ability to weight-bear, and to withstand substantial forces.

The hip also gets plenty of support from surrounding musculature (e.g., the gluteals, and several others) as well as a series of ligaments.

So, what can go wrong - why can early hip degeneration occur?

Inevitably, the femur and the acetabulum are not designed to be in direct contact with one another. The joint space should rather be filled with synovial (articulate) fluid. This fluid and the smooth hyaline cartilage which covers the end of the relevant bones allows flawless, friction-free movement in a healthy joint.

However, a mobile, weight-bearing joint is always prone to degeneration, and impact sports like tennis on harder surfaces can accelerate this process. The joint space can rapidly narrow, and osteophytes (excess bony growths) can develop. These often lead to substantial pain and functional restrictions, e.g., during rapid changes of directions, as well as gradually during simple activities of daily living too.

What happened to Sir Andy Murray’s hip?

It is well-known that the former World Number 1 in Men's Singles (by the Association of Tennis Professionals - ATP) has suffered a number of devastating, career threatening right hip injuries and he has previous had arthroscopic surgery – a 'clean-up' to try to preserve the integrity of his worsening cartilage and labrum (which was also torn).

Unfortunately, in professional athletes, arthroscopic surgery in the hip is often not successful enough as they cannot replenish the damaged cartilage.

Living with constant pain, Andy decided that more drastic measures were needed to help prolong his tennis career. Only an artificial implant would be enough to help solve the problem and he therefore opted for a hip resurfacing surgery.

What is hip resurfacing surgery, and what are the advantages of this procedure over a conventional Total Hip Replacement (THR)?

Hip resurfacing is an alternative procedure to THR surgery. It is an open surgery which involves reshaping the bone of the femoral head (the ball of the thigh bone) and the acetabular socket to accept two new metal implants that will function as the new articular surface.

Hip resurfacing preserves far more bone of the femur which is crucial for such young patients (Andy was 31 at the time of his operation) who will likely require future surgery.

As well as the implant's large surface, it also provides greater stability than a conventional THR. Hence the chances of returning to professional tennis are far greater.

Why may hip resurfacing not suit you? Just a few examples...

• If your bone density is reduced, you may rather require a cemented THR, so the metal implant will not fail.
• Research studies reveal that the outcome for a THR is better over the age of 65.
• THRs have a longer life span and revision surgeries are to be avoided when patients are more frail or have comorbidities.
• Both the artificial ball and the socket of the resurfacing parts are made of cobalt-chromium metal alloy, creating a metal-on-metal articulation. Unfortunately, some patients can have an allergic reaction to the microscopic metal debris which the friction produces during the joint's mobility. The implant can be replaced with a THR, which are often ceramic and polyethylene-made implants, meaning no allergic reaction.

Summary

Whether you have a degenerative hip condition, an 'Andy Murray Hip' or a THR, at the White House Clinic, we can help you with prehab and post-op rehabilitation.

Do not let your hip be the source of pain, stiffness and consequently lead to a reduction of your activity levels!

If Andy can do it and remains to be competing at the highest level in world tennis, then why can’t you continue doing the things you enjoy best and be pain-free. Andy’s saying of ‘Better Never Stops’ is quite fitting…