I am writing to support the Medicare coverage of
hip resurfacing as an alternative to traditional
hip replacement.
As an orthopaedic surgeon with experience with
both hip replacement and hip resurfacing surgery,
I feel that hip resurfacing surgery is more than
just an interim treatment for end-stage
arthritis. As a newer treatment, hip resurfacing
may not have the data to support its longevity
yet, but ongoing research does suggest the
possibility of lasting as long or longer than a
hip replacement. Furthermore, the determination
of candidacy for hip resurfacing should be based
more upon a patient''s bone quality than their
chronologic age. The ability to preserve femoral
bone with a resurfacing has several potential
advantages if there is a need for future surgery,
including: a less complicated revision surgery
and thus a less costly repair; quicker recovery
from a revision procedure, and more options for
revision surgery.

A recent article published in the orthopaedic
literature found that older patients who had hip
resurfacing had equivalent results to younger
patients (Journal of Bone and Joint Surgery,
2008, suppl 3, 27-31).

In conclusion, I feel strongly that hip
resurfacing should be covered by CMS because it
provides an alternative treatment to total hip
replacement that has proven efficacy and
potential advantages.