Hip Resurfacing Overview

Hip resurfacing is a modern alternative to traditional total hip replacement, designed especially for younger, active patients with advanced hip arthritis. Unlike classic hip arthroplasty, hip resurfacing preserves more of your natural bone, offering unique benefits and its own set of risks.

What Is Hip Resurfacing?

Hip resurfacing is a bone-conserving procedure for treating advanced arthritis of the hip. Rather than removing the femoral head (the top of your thigh bone), the surgeon carefully trims and caps it with a smooth metal covering. The damaged cartilage and bone from the socket (acetabulum) are also removed and replaced with a metal cup, just as in a total hip replacement. The result is a metal-on-metal hip joint that is closer in size to your natural hip anatomy.

Key Steps in Hip Resurfacing

• Trimming, not removing, the femoral head

• Placing a metal cap over the femoral head

• Fitting a metal cup into the hip socket

• Closing the joint for smooth articulation

The operation typically takes 1.5–3 hours and can be performed under general or regional anesthesia.

Advantages of Hip Resurfacing

• Bone preservation: Retains more of the natural femoral bone compared to traditional replacement.

• Easier revision: If the implant fails years later, conversion to total hip replacement is often simpler.

• Larger ball size: The “ball” of the joint is closer in size to a natural hip, reducing the risk of dislocation.

• Potentially more natural gait (walking pattern): Some studies suggest subtle improvements in walking compared to traditional replacements, though differences are minor.

Disadvantages & Risks

• Femoral neck fracture: A unique risk to hip resurfacing (not present in classic replacement) where the preserved neck bone breaks, often requiring revision surgery.

• Metal ions risk: Metal-on-metal friction may release tiny particles (ions), causing local tissue reaction, pain, and even systemic (body-wide) effects. This has led to a decline in usage in recent years and careful patient selection.

• Other risks: Infection, blood clots, nerve or vessel injury, hip dislocation (rare), and standard anesthesia risks.

Who Is a Candidate for Hip Resurfacing?

• Younger (<60), active adults with strong, healthy bone

• Typically, larger-framed patients (often but not always male)

• Those wanting to postpone or ease a future standard hip replacement

• NOT recommended for people with osteoporosis or weaker bone, small-framed individuals, or many women due to increased risk of fracture

Always consult with an orthopedic surgeon to determine the best approach based on age, activity, anatomy, and health.

Recovery and Rehabilitation

• Hospital stay: Usually 1–4 days

• Weight-bearing: May begin as soon as the same day—using crutches, cane, or walker depending on comfort and bone strength

• Pain management: Multiple medications available; opioids only short-term and as needed

• Physical therapy: Begins soon after surgery, focusing on regaining motion and strength

• Daily activity: Most return to basic activities within 6 weeks, with ongoing improvements over months

Revision and Outcomes

Hip resurfacing may be easier to revise if needed in the future because the femoral bone is preserved. Implants generally last 15–20 years, but revision depends on age, activity, and other health factors.