Hip resurfacing is an alternative to total hip replacement in which the damaged surfaces of the hip joint are reshaped and capped with smooth metal components, rather than removing the femoral head entirely. It is most suitable for younger, active male patients with good bone quality.
An incision is made over the side of the hip. The damaged surface of the femoral head is trimmed and capped with a smooth metal shell. The socket is prepared and lined with a corresponding metal cup. This preserves more of the natural bone compared to a total hip replacement. The operation typically takes one to two hours.
Hip resurfacing may be recommended for younger, active patients (typically men under 65) with severe hip arthritis and good bone quality. It preserves bone stock, potentially making future revision surgery easier, and allows a larger bearing surface which may reduce the risk of dislocation and permit higher levels of activity.
The same non-operative options as for total hip replacement: physiotherapy, weight management, pain medication, activity modification, and injections. A total hip replacement is the main surgical alternative.
Thorough pre-assessment. A CT scan or MRI may be required to confirm suitability. Metal ion blood tests may be arranged as part of the screening. The same general preparation as for total hip replacement applies.
Excellent activity levels are achievable, often including impact sports. Preservation of bone stock. Large bearing diameter reduces dislocation risk. In the right patient, results can be as good as or better than conventional replacement.
Usually minimal with resurfacing.
Expected around the hip.
Some patients experience groin discomfort in the early months that usually settles.
Fracture of the preserved femoral neck, requiring conversion to total hip replacement. Most common risk, approximately 1–2%.
Metal-on-metal bearings release metal ions. Blood levels are monitored. High levels may cause soft tissue reactions (ARMD).
Inflammatory reaction to metal particles causing pain and tissue damage. May require revision.
Deep infection in approximately 1% of cases.
Sciatic or femoral nerve stretching is rare.
Usually performed under spinal or general anaesthesia, similar to total hip replacement.
Recovery is similar to total hip replacement. Most patients mobilise on the day of surgery. Hospital stay is typically one to three days. Crutches for several weeks. Many patients return to high-activity pursuits including running and impact sports, which is a key advantage over conventional replacement. Full recovery takes three to six months.
Standard follow-up at two weeks, six weeks, three months, and one year. Blood metal ion levels are checked periodically. Long-term surveillance is important.
Women, older patients, those with small femoral heads, osteoporosis, or certain hip anatomy are at higher risk of complications. Total hip replacement is more appropriate for these groups.
Some older metal-on-metal hip designs had high failure rates. Modern resurfacing implants with established track records (such as the Birmingham Hip Resurfacing) have excellent long-term data when used in the right patients.
Many patients return to running and impact sports. This is one of the main advantages of resurfacing over conventional replacement.