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2026 Guide

Hip Resurfacing Surgery Guide

Complete guide to hip resurfacing — costs, recovery timeline, success rates, and how to find the right surgeon.

What Is Hip Resurfacing?

Hip resurfacing is a bone-conserving alternative to total hip replacement. Instead of removing the entire femoral head, the surgeon trims and caps it with a smooth metal shell. A matching metal cup is placed in the acetabulum (socket). This preserves the natural ball of the femur and maintains more of the patient's anatomy. Hip resurfacing was developed for younger, active patients who want to preserve bone stock for potential future revision surgery and maintain a more natural-feeling hip.

Who Is a Good Candidate?

Ideal candidates for hip resurfacing:
• Males under 60 with good bone quality (larger femoral heads have better outcomes)
• Active patients who want to return to vigorous activities
• Patients with hip arthritis but healthy bone (no cysts, no avascular necrosis)
• Those who want to preserve bone for potential future revision

Hip resurfacing may NOT be ideal for:
• Women (higher failure rates with smaller femoral heads)
• Patients over 65 (osteoporotic bone increases fracture risk)
• Patients with femoral neck cysts, kidney disease, or metal sensitivity
• Avascular necrosis with large necrotic areas

Hip Resurfacing vs Total Hip Replacement

Resurfacing advantages: Preserves femoral bone, lower dislocation rate, more natural hip mechanics, easier revision if needed later.

Resurfacing disadvantages: Risk of femoral neck fracture (1-2%), metal ions released into bloodstream, limited to larger patients with good bone, fewer surgeons trained in the technique.

Total hip advantages: More versatile (works for all patients), wider surgeon availability, multiple bearing options (ceramic, polyethylene), well-established long-term data.

Cost and Recovery

Hip resurfacing costs $30,000 to $60,000 before insurance — similar to total hip replacement. Recovery is comparable: walking same day, crutches for 2-4 weeks, return to full activity in 3-6 months. Resurfacing patients often report a more natural-feeling hip and fewer activity restrictions long-term.

Frequently Asked Questions

Is hip resurfacing better than hip replacement?
Neither is universally better. Resurfacing preserves more bone and may feel more natural, but it is only appropriate for select patients (younger males with good bone quality). Total hip replacement works for nearly everyone and has more long-term outcome data.
How long does a resurfaced hip last?
Well-performed hip resurfacing in appropriate candidates can last 15-25+ years. Outcomes are highly dependent on surgeon experience and patient selection. If a resurfacing fails, it can be revised to a total hip replacement.
Why is hip resurfacing less common in women?
Women typically have smaller femoral heads, which increases the risk of component failure in metal-on-metal bearings. Studies show higher revision rates in women. Some surgeons will perform resurfacing in women with larger anatomy, but total hip replacement is generally preferred.
Are there risks from metal ions?
Metal-on-metal bearings release cobalt and chromium ions into the bloodstream. In well-functioning implants, ion levels remain low. However, abnormally high levels can cause soft tissue damage. Regular blood monitoring is recommended for the first few years after surgery.

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