Why is the U.S. so far behind in the treatment of hip arthritis? I'm finding all kinds of doctors in England, Australia, and Europe who do joint resurfacing. It seems to be very limited here in our country. I want this procedure done but I really don't want to have to travel so far. What do you suggest?

You can have this operation done in the United States. But depending on where you live, you may have to do a little traveling. Surgeons at specialty centers such as at a joint replacement institute or institute for advanced joint procedures offer joint resurfacing.

Hip joint resurfacing is a type of hip replacement that removes the arthritic surface of the joint but takes far less bone than the traditional total hip replacement.

Special powered instruments are used to shape the bone of the femoral head so that the new metal cap will fit snugly on top of the bone. The cap is held in place with a small peg that fits down into the bone.

The acetabulum (hip socket) may remain unchanged. But more often it is replaced with a thin, metal cup. The acetabular component is pressed into place in the socket.

Some of the holdup in the U.S. can be attributed to the U.S. Food and Drug Administration (FDA) regulations. Devices from U.S. manufacturing companies must be approved by the FDA before they can be used routinely. This requires many studies on cadavers (joints preserved after death for study) and on humans via clinical trials.

Not until they are deemed safe and effective are these implants released for use in the general population. At the present time, there are at least two implants that have full FDA approval. Others are in line awaiting approval. Once that road block has been set aside, more surgeons around the U.S. will have the necessary training to perform this procedure.