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Hip ReplacementSecond Opinion Guide

Should you get a second opinion for hip resurfacing?

Hip resurfacing is an alternative to total hip replacement that preserves more bone and may allow a more active lifestyle. However, it is appropriate only for specific patients and has metal-on-metal bearing concerns that require careful monitoring. A second opinion from a surgeon who performs high volumes of resurfacing (not all hip surgeons do) is valuable.

Red flags - consider a second opinion if you notice these

  • The surgeon does not regularly perform hip resurfacing and cannot quote their personal outcomes
  • You are a woman of childbearing age - metal ion concerns are higher with resurfacing
  • You have a small femoral head or significant hip deformity that makes resurfacing technically difficult
  • The surgeon did not discuss metal ion monitoring and what it involves
  • Total hip replacement was not discussed as a comparison

Questions to ask the second surgeon

  1. 1Am I a good candidate for resurfacing versus total hip replacement based on my anatomy?
  2. 2How many hip resurfacings do you perform per year?
  3. 3What metal ion monitoring do you recommend after resurfacing, and what are the triggers for revision?
  4. 4If resurfacing fails, can it be converted to a standard total hip replacement?
  5. 5What activities will I be able to do after resurfacing that I might not be able to do after total hip replacement?

What to expect from a second opinion visit

Hip resurfacing should be performed by a high-volume specialist. Seek a second opinion from a surgeon who performs at least 30-50 resurfacings per year and who can show you their personal data on outcomes and complications. Bring your hip X-rays and MRI if available.

Common questions

Who is the ideal candidate for hip resurfacing?
The best candidates are men under 60 with good bone quality, a large femoral head, and significant hip arthritis who want to remain highly active. Women are not ideal candidates due to smaller femoral head size and concerns about metal ion exposure. Patients with bone cysts, avascular necrosis, or significant deformity are also generally not good candidates.
What are the risks of metal-on-metal hip resurfacing?
Metal-on-metal bearings release cobalt and chromium ions into the bloodstream and local tissue. High metal ion levels can cause local tissue reactions (pseudotumors) and rarely systemic effects. Regular blood metal ion monitoring is required, and some patients with elevated levels need revision surgery even without symptoms.

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