LLR Policy for Hip Resurfacing

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Policy for Hip Resurfacing

Category

Threshold Criteria

In hip resurfacing, the femoral head is not removed, but is instead trimmed and capped with a smooth metal covering. The damaged bone and cartilage within the socket is removed and replaced with a metal shell, just as in a traditional total hip replacement. The procedure is contraindicated in females.

Eligibility

LLR ICB  will only fund this procedure if the following criteria is met
 
The patient has been assessed by Musculoskeletal Services and diagnosed as suffering from end-stage osteoarthritis suitable for referral for consideration of surgery,

              AND

The patient has fully engaged with conservative measures for a period of at least six months (clearly detailed throughout the patient’s primary care record or via Musculoskeletal Services’ clinic letters), as detailed within this policy, and this has failed to improve the symptoms of the patient,

              AND

The patient:
– Is suffering from intense or severe persistent pain with moderate or severe functional impairment

               OR
– Has significant instability of the hip joint with significant functional impairment*,

                OR
– Has radiological features of severe disease with moderate functional impairments;

              OR
– Has radiological features of moderate disease with significant functional impairment* or instability of the hip joint and is suffering from.

              OR
– The patient has severe persistent pain that is causing severe functional impairment which is compromising their mobility to such an extent that they are in immediate danger of losing their independence and joint replacement would relieve this, and conservative management as set out in this policy is contra-indicated.
 
             OR
– The patient is at risk of destruction of their joint of such severity that delaying surgical correction would increase the technical difficulties of the procedure.


*Significant functional impairment is defined as:
– Symptoms preventing the patient fulfilling routine work or educational responsibilities
– Symptoms preventing the patient carrying out routine domestic or carer activities
ARP 55 Review Date: 2026

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