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Hip Resurfacing

Hip resurfacing caps the damaged femoral head with a metal shell rather than removing it entirely. The socket gets a metal cup. Because the femoral stem is left intact, revision surgery is simpler if it's needed years later. It's best suited for younger, active patients with good bone quality who plan to stay physically active for a long time.

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Hip Resurfacing surgery - orthopaedic procedure overview and what to expect

Who Needs Hip Resurfacing?

Men under 60 with large femoral heads, good bone density, and end-stage hip arthritis from osteoarthritis or avascular necrosis are the strongest candidates. Women face higher risks: smaller femoral heads raise fracture risk, and metal ion sensitivity is more common. Patient selection is strict for this reason, and most surgeons are more conservative with female patients.

What to Expect

1
X-ray and MRI to assess femoral head viability and bone quality
2
DEXA scan may be ordered to confirm bone density
3
Surgery takes 1.5-2.5 hours under spinal or general anesthesia
4
The femoral head is shaped and capped; the socket is replaced with a metal cup
5
Hospital stay of 1-2 days
6
Walking with a walker the day after surgery

Recovery Timeline

Days 1-3

Walking with a walker starts the day after surgery. Most patients have no weight-bearing restrictions.

Weeks 1-3

Home recovery. Cane or walker as needed. Hip precautions are less strict than after total hip replacement.

Months 1-2

Walking without assistance. Stationary cycling and physical therapy.

Months 3-6

Back to recreational activity: hiking, cycling, swimming, golf.

Months 6-12

Return to higher-impact activity. Running, skiing, and contact sports are achievable for many patients.

Risks & Complications

  • Femoral neck fracture (1-2%, higher risk in women and patients with small femoral heads)
  • Metal ion release — cobalt and chromium levels require monitoring
  • Pseudotumor (soft tissue reaction to metal ions)
  • Aseptic lymphocyte-dominated vasculitis-associated lesions (ALVAL)
  • Avascular necrosis of the femoral head
  • Dislocation (rare — lower rate than total hip)

Frequently Asked Questions

Is hip resurfacing better than total hip replacement for young patients?

For younger men with large femoral heads and solid bone quality, resurfacing results at 10-15 years are at least as good as total hip replacement. The preserved bone makes revision surgery easier down the road. For women, smaller femoral heads and higher metal sensitivity tip the scales toward total hip for most.

Can I run after hip resurfacing?

Most surgeons are comfortable with jogging and recreational running after full recovery. Resurfacing patients tend to be more active than total hip patients — though that partly reflects who gets selected for the procedure. High-impact activities are generally allowed after 12 months, whereas most total hip centers advise against running long term.

What is the metal ion concern with hip resurfacing?

Metal-on-metal bearings shed small amounts of cobalt and chromium as they wear. Most patients have low blood levels and no symptoms. A minority develop elevated levels, pseudotumors, or soft tissue reactions that require revision. Annual metal ion blood testing is standard follow-up at most resurfacing centers.

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Estimated Cost

$25,000 - $55,000 (before insurance). Covered by most insurance plans; requires pre-authorization at some insurers.

Full cost breakdown

Related Specialty

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Other Procedures

Total Knee ReplacementTotal Hip ReplacementACL ReconstructionRotator Cuff RepairArthroscopic SurgerySpinal Fusion

This information is for educational purposes only. Costs are estimates and vary by location, surgeon, and insurance. Always consult a qualified healthcare provider.