- Hip resurfacing caps the femoral head rather than removing it, preserving more natural bone than a total hip replacement.
- Studies report excellent implant survival at with 93% survival of the implant in male patients at 23years, according to the national joint replacment registry. Other studies show similar outcomes,
(Molloy J, Handford C, Coolican J, Molloy T, Walter W. Long-Term Outcomes of Birmingham Hip Resurfacing Arthroplasty: A Systematic Review of Independent Series with At Least 10 Years of Follow-up. JB JS Open Access. 2024 Mar 25;9(1):e23.00057. doi: 10.2106/JBJS.OA.23.00057. PMID: 38529209; PMCID: PMC10959564.) - Patients with hip resurfacing may also returnt to high levels of athletic sports
(Morse KW, Premkumar A, Zhu A, Morgenstern R, Su EP. Return to Sport After Hip Resurfacing Arthroplasty. Orthop J Sports Med. 2021 May 6;9(5):23259671211003521. doi: 10.1177/23259671211003521. PMID: 33997077; PMCID: PMC8113959.) - Outcomes are best in younger, more active patients with good bone quality.
- Bone preservation can make future revision to a total hip replacement more straightforward.
- Metal-on-metal wear is a recognised risk, so new prostheses using ceramic on ceramic are now used.
- Careful patient selection remains the single most important factor in long-term success.
Hip resurfacing is a surgical procedure sometimes performed in place of a hip replacement. It is designed to relieve pain and restore function for people with hip joint damage, most often caused by osteoarthritis.
Unlike a total hip replacement, hip resurfacing retains more of the natural bone by reshaping and capping the femoral head rather than removing and replacing it entirely. Over the years a clearer picture has emerged of the long-term results, particularly for younger or more active patients who place higher demands on their joints.
What Is Hip Resurfacing?
Hip resurfacing is a bone-conserving alternative to total hip replacement in which the femoral head is trimmed and capped with a smooth metal covering, and the socket is lined with a matching component. Because the femoral neck and head are preserved, the reconstructed joint closely reproduces natural hip anatomy. You can read more on our hip resurfacing page.
Durability and Implant Longevity
One of the key benefits of hip resurfacing is the long-term durability of the implant. Many patients experience excellent implant survival 10 to 15 years after surgery.
The procedure tends to perform best in younger patients with good bone quality, as strong bone supports the resurfaced femoral head. In these cases, implant longevity can match and sometimes exceed that of a traditional total hip replacement. In older patients, or those with weaker bone structure, outcomes are less predictable and revision surgery may become necessary because of loosening, wear or fracture of the femoral neck.
Careful patient selection therefore remains a critical factor in achieving positive long-term results.
Hip Resurfacing Versus Total Hip Replacement
| Factor | Hip Resurfacing | Total Hip Replacement |
| Bone removed | Femoral head reshaped and capped, neck preserved | Femoral head and neck removed and replaced with a stem |
| Ideal candidate | Younger, active patients with good bone quality | Broader range of ages and bone quality |
| Activity potential | Often suits return to higher-impact activity once cleared | Generally suits moderate and low-impact activity |
| Revision surgery | Usually more straightforward due to preserved bone | More complex, as bone stock is already reduced |
| Main long-term concern | Metal-on-metal wear and femoral neck fracture | Bearing wear, loosening and dislocation |
Function and Activity Levels
Long-term functional outcomes after hip resurfacing are generally positive, particularly for active patients. Because more bone is preserved and the mechanics of the reconstructed hip closely resemble the natural joint, many patients report a greater sense of stability, lower dislocation risk, and better range of motion compared with a traditional hip replacement.
For suitable patients this can allow a return to higher-impact activities such as running, tennis or manual work once approved by their surgeon. Sustained pain relief and improved mobility years after surgery are among the main reasons hip resurfacing continues to be considered for younger patients who wish to maintain an active lifestyle.
Revision Surgery and Bone Preservation
Another advantage of hip resurfacing is the relative ease of revision if it becomes necessary. Because femoral bone is largely conserved during the initial procedure, converting a failed resurfacing to a total hip replacement is often more straightforward than performing a revision hip replacement after a conventional implant.
This bone preservation is particularly valuable for younger patients who may outlive their first implant and require further surgery later in life. Revision rates vary depending on implant design, surgical technique and patient factors, though outcomes have improved over time alongside advances in implant design and surgical experience.
Potential Risks and Long-Term Considerations
As with any surgery, hip resurfacing carries risks. One of the main concerns is metal-on-metal wear, which can release metal ions into the bloodstream and, in some cases, cause local tissue reactions or other complications.
For this reason, patients with metal-on-metal resurfacing implants are advised to have long-term follow-up and monitoring. Not all patients experience these issues, and modern monitoring protocols allow potential problems to be identified early. It does, however, underline the importance of regular reviews and open communication with your healthcare provider. Long-term implant performance data for Australia is published by the Australian Orthopaedic Association National Joint Replacement Registry.
Hip Resurfacing With Dr David Slattery
The long-term outcomes of hip resurfacing are favourable for younger, active individuals with good bone quality. Implant durability, preserved bone stock and sustained functional improvement make it an appealing option for carefully selected patients, particularly those managing hip arthritis at a relatively young age.
At Dr David Slattery’s clinics, patients are carefully assessed to ensure the best possible outcomes, with surgical expertise and ongoing follow-up throughout. To find out whether hip resurfacing may be suitable for you, get in touch to arrange a consultation.
Frequently Asked Questions
How long does a hip resurfacing last?
Hip resurfacings should last over 20years, based upon current data in over 90% of patients. Longevity is strongest in younger patients with good bone quality and can be less predictable in older patients or those with weaker bone.
Who is a good candidate for hip resurfacing?
Hip resurfacing generally suits younger, active patients with good bone quality and hip damage caused by osteoarthritis. It is less suitable for patients with osteoporosis, significant femoral neck deformity or poor bone stock.
Can you run after hip resurfacing?
Many resurfacing patients return to higher-impact activities such as running once their surgeon has cleared them. Because more natural bone and hip mechanics are retained, activity tolerance is often higher than after a conventional hip replacement, though clearance depends on individual healing.
What happens if a hip resurfacing fails?
A failed resurfacing is usually converted to a total hip replacement. Because the femoral bone was largely preserved during the original procedure, this revision is often more straightforward than revising a conventional hip replacement.
