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Dr. Richard Conn, a Hattiesburg orthopedic surgeon, and his patient, Orville Todd, 60, who had hip resurfacing surgery, an alternative to a full hip replacement.

A constant pain in her hip drove Ellicott City, Md., resident Debbie Ruppert all the way to Mississippi to seek an innovative new hip resurfacing procedure.

"I was living on Motrin and I was going to a doctor in Maryland and he was giving me cortisone shots," Ruppert, 52, said. "They helped for a while, but then the pain returned. I'm a very active person and I try to take a three-mile walk every day. I wasn't walking anymore. I had a 45-minute drive to work, and I was in so much pain from sitting in that position for that long. I was in so much pain. I just had to get out of the pain."

Ruppert's son works in medical equipment sales in Mississippi and was familiar with the hip replacement and resurfacing work being done by Richard Conn, MD, at Southern Bone and Joint Specialists PA in Hattiesburg. He told his mother she should come down to the Magnolia State for the resurfacing procedure.

Conn became the first physician in the U.S. to perform resurfacing after the FDA approved the Cormet Hip Resurfacing System in August 2007. The implants are distributed by the Stryker Orthopedics Corp., of Mahwah, N.J.

Hip resurfacing is an attractive option for younger and more active osteoarthritis patients, Conn said. The procedure allows more of the natural bone to be preserved, which increases stability and improves the potential for greater motion and mobility. The end of the femur is capped with a metal covering - a strong cobalt chromium metal - which fits into a metal cup that sits in the hip socket. The femoral head is reshaped and "resurfaced," rather than removed.

Conn trained with the surgeons who designed the Cormet Hip Resurfacing System in England, and he now trains surgeons in the U.S. to perform the procedure and select the appropriate patients.

"You have to have higher quality of bone available for resurfacing," Conn said. "If you're not a suitable candidate for hip resurfacing, total hip replacement is a great surgery."

His first resurfacing patient, Orville Todd, 60, had experienced hip pain for five years and had a bad limp, which he said made his job difficult. "I just couldn't stand it any longer," Todd said. "Now I have no pain and full range of motion."

Recovery time from resurfacing is fairly quick. Conn said his staff uses a "rapid recovery program" to get patients on their feet the same day as their surgery, unless it was very late in the day.

"I have them stand my hip and knee patients up on their feet on day one to get their head above their feet and their blood circulating. On day two, I have them walking."

Ruppert said she recuperated much faster than she anticipated. "I really thought I was going to be on a walker and cane for a while. I used the walker for about 10 days and I never used the cane. I flew back to Maryland after two weeks. My husband was surprised at how well I was doing."

Conn said the hip resurfacing procedure has actually been around for years, but fell out of favor because of problems with the materials, but technology has allowed for better and stronger materials, and candidates for the procedure are carefully screened.

Resurfacing is best for males 60 and under and females 55 and under, Conn said, people who are still pretty strong and active. Bone density scans are performed on females over age 50, and if there is any osteoporosis, he performs total hip replacements instead of resurfacing.

"This isn't someone who just wants to get out of pain, get in the car and go to the beauty parlor," Conn said. "These people want to go at it full bore."

One such patient was a 34-year-old marathoner from Natchez who had developed arthritis in his hip due to the pounding from running. He had the resurfacing a few months ago and is now biking and swimming.

"Swimming is probably the best rehab you can have from hip surgery," Conn said. "For aggressive athletes, like this fellow, it'll be six months before I let him go back to running."

Ruppert attributes her arthritic hip to the high impact aerobics classes she taught five times a week 20 years ago. "That hard impact on my joints is what did it," she said. "Now, most of the classes are low-impact. I learned my lesson."

Six months after her surgery, she said she is "pretty much back to the way I was. I take some aerobics classes and some light weight lifting classes. I do squats and it hasn't bothered me. I walk three miles a day. I'm so glad I had the surgery."

Conn has performed 50 hip resurfacings in the past year. He said it takes about 90 minutes to perform a resurfacing and an hour to do a total hip replacement. He has performed 9,000 joint replacements in his 25-year career. "The most common thing I do is a total knee replacement. I do 500 knees in a year and 200 hips."

Although the procedure is relatively new, more and more patients are asking about it, he said. "The majority of patients come into the office much better educated about what they want. There may be surgeons that don't like that interaction, but for me it's great. I've always strived to stay cutting edge. It pushes me further."

Some patients have even watched videos about the surgery on the Internet.

"I think it's great that patients come with some understanding of what they're getting into," he said.

The resurfacing results are estimated to last about 10 years, but Ruppert isn't worried yet about facing another resurfacing or even total hip replacement. For now, she's just happy to return to her active lifestyle, and praises Conn.
"If I do have to have something done, I'm going back there to do it," she said.

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