#treatment - Hip

Hip Resurfacing

  • Hip resurfacing is one specific type of hip replacement
  • With hip resurfacing, instead of the ball part of the joint being removed and replaced, it is shaved and then resurfaced with a circular metal cap
  • The choice of whether to have a traditional hip replacement or a hip resurfacing procedure is complex, and should be discussed with your surgeon
  • The risks of the surgery are pretty much the same as for traditional hip replacement
  • The surgical outcomes are pretty much the same as for traditional hip replacement

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One particular type of hip replacement that has attracted a lot of publicity over the past few years is Hip Resurfacing Arthroplasty (HRA). In HRA, instead of the bone of the ball of the hip joint (the femoral head) being cut away completely and replaced with a new ball, the surface of the femoral head is shaved off, and a new dome-shaped surface is attached onto the top instead. This metal dome is fixed into a large metal socket in the pelvis.

Hip resurfacing arthroplasty prostheses - a metal 'mushroom' is placed onto the top of the shaved femoral head, and this fits into a metal shell that is inserted into the acetabulum (socket) of the pelvis.

Hip resurfacing arthroplasty prostheses – a metal ‘mushroom’ is placed onto the top of the shaved femoral head, and this fits into a metal shell that is inserted into the acetabulum (socket) of the pelvis.

A post-operative X-ray showing a hip resurfacing prosthesis in place.

A post-operative X-ray showing a hip resurfacing prosthesis in place.

The potential advantages of hip resurfacing over traditional hip replacement are that a) the joint is actually more stable, and less liable to potential dislocations, and b) less bone is removed, meaning that future potential revision surgery may be technically easier.

However, there are potential disadvantages with hip resurfacing. First, it relies on a metal-on-metal bearing, which may be a problem in people with metal sensitivity (as detailed above). Second, there is a risk of the femoral neck (the bone beneath the ball part of the joint) fracturing either during or after the operation. If this does occur, then the procedure has to be converted to a traditional hip replacement.