What is hip resurfacing?

Hip resurfacing is surgery to treat chronic hip pain due to arthritis and other hip conditions. It involves implanting a new socket into your hip joint, similar to hip replacement. However, hip resurfacing keeps more of the femur (thighbone) than hip replacement. Hip resurfacing can restore pain-free range of motion and hip function.

Your hip joint is a ball and socket joint. The ball of the femur fits into a socket in your pelvic bone. In both hip replacement and hip resurfacing, surgeons clean out the socket and line it with an artificial surface. 

The difference between the procedures lies in what happens to the femur. Hip resurfacing involves reshaping the ball or head of the femur, fitting it with a metal cap, and relocating the ball back into the socket.

Hip replacement involves removing the ball or head of the femur and some of the bone below the ball, called the femoral neck. Surgeons then insert a long stem with an artificial ball into the thighbone. The artificial ball inserts into the socket to form the hip joint. 

Hip resurfacing has some advantages over hip replacement. It keeps more of the femur intact and provides greater hip stability after surgery. You can also have a hip replacement in the future if needed.

Hip resurfacing is major surgery with serious risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having hip resurfacing. 

Why is hip resurfacing performed? 

Your doctor may recommend hip resurfacing to treat chronic hip pain that interferes with your daily activities or decreases your quality of life. Not everyone is a candidate for hip resurfacing. The best candidates for hip resurfacing are younger than 60, live an active lifestyle, and have strong bones and a large frame. Males tend to meet these requirements more often than females.

People with kidney problems or allergies to metal should not have this surgery. The artificial surfaces in hip resurfacing are metal and can release metal ions into the blood. This is usually not a problem for people with healthy kidneys. 

Your doctor will only consider hip resurfacing if other treatment options have not improved your condition. Ask your doctor about all of your treatment options and consider getting a second opinion.

Your doctor may recommend hip resurfacing to treat chronic hip pain due to degenerative diseases including: 

  • Dysplasia, which is when the hip joint doesn’t develop normally causing the joint to wear out
  • Inflammatory forms of arthritis, including rheumatoid arthritis
  • Osteoarthritis, which is the breakdown of cartilage and bone
  • Osteonecrosis, or death of bone. Osteonecrosis is a rare condition.
  • Traumatic arthritis, which is similar to osteoarthritis and develops after a fracture or severe sprain or strain

Who performs hip resurfacing?

Orthopedic surgeons perform hip resurfacing. Orthopedic surgeons are specially trained to treat problems of the bones and joints. They perform surgery and prescribe other treatments.

How is hip resurfacing performed?

Your hip resurfacing will be performed in a hospital or surgery center. It is major surgery that involves a large incision in the thigh and hip. The incision is usually larger than for hip replacement because the surgery is more difficult. 

Your surgeon will dislocate your hip joint, trim your femur bone, and fit it with a metal cap. Then, your surgeon removes the damaged cartilage from the hip socket and replaces it with a metal liner. Finally, your surgeon will relocate your hip joint to complete the surgery. 

Types of anesthesia 

Your surgeon will perform your hip resurfacing using either general anesthesia or regional anesthesia. 

  • General anesthesia is a combination of intravenous (IV) medications and gases that put you in a deep sleep. You are unaware of the surgery and do not feel any pain. You may also receive a peripheral nerve block infusion in addition to general anesthesia. A peripheral nerve block infusion is an injection or continuous drip of liquid anesthetic. The anesthetic flows through a tiny tube inserted near your surgical site to control pain during and after surgery.
  • Regional anesthesia is also known as a nerve block. It involves injecting an anesthetic around certain nerves to numb a large area of the body. You will likely have sedation with regional anesthesia to keep you relaxed and comfortable.