Hip Resurfacing Surgery

What is hip resurfacing?

Hip resurfacing is surgery to repair damage inside your hip joint. Healthcare providers sometimes call it a hip resurfacing arthroplasty.

Resurfacing is similar to a hip replacement (arthroplasty), but it involves replacing less of your natural hip joint. Your surgeon will replace only your hip socket (acetabulum) with a prosthetic piece. Then, they’ll trim and reshape (resurface) the head of your thigh bone (femur) to fit securely into the prosthetic acetabulum.

What does hip resurfacing treat?

A healthcare provider might recommend hip resurfacing surgery if you have severe symptoms that don’t get better after trying nonsurgical treatments like activity modifications, physical therapy or medications. Symptoms that can cause you to need resurfacing can include:

• Hip pain.
• Stiffness or decreased range of motion (how far you can move your hip).
• Limited mobility (difficulty walking or moving).
• Swelling.
• Instability (not feeling steady or balanced on your hip).

Arthritis is the most common reason people need hip resurfacing. Most people who choose to have resurfacing surgery have osteoarthritis, but some people with rheumatoid arthritis may need it, too.

Who is a good candidate for hip resurfacing?

Not everyone is a good candidate for hip resurfacing. Because your surgeon won’t replace your entire hip joint, your bone health is more of a factor than in hip replacement. Specifically, your femur needs to be strong and healthy enough to be resurfaced.

In general, good candidates for hip resurfacing include people who:

• Are younger than 60.
• Are physically active.
• Have strong, healthy bones.

The size of your hip bones is an important part of whether or not hip resurfacing will be a good option for you. Men and people assigned male at birth (AMAB) typically have larger bones than women and people assigned female at birth (AFAB). This means people AMAB are usually better suited to hip resurfacing than people AFAB. But your bone size is more important than your sex assigned at birth.

Talk to your healthcare provider or surgeon. They’ll suggest which type of hip surgery is best for you based on your body, unique needs and situation.

How should I prepare for hip resurfacing?

Your healthcare provider or surgeon will help you get ready for surgery. You might need:

• A physical exam to make sure you’re healthy enough for surgery.
• Blood tests.
• An electrocardiogram to check your heart health.
• A dental exam to reduce your risk of developing an infection after surgery.
• Imaging tests, including a hip X-ray. You might also need an MRI or a CT scan.

Tell your provider and surgeon about any medications and over-the-counter supplements you take. You may have to stop taking them before your surgery.

Your surgeon will tell you when you should stop eating and drinking the day before your surgery. Most people need to avoid eating and drinking eight hours before their surgery. Your surgeon will also tell you which medications are safe to take with a sip of water the morning of your surgery.

What happens during hip resurfacing?

On the day of your surgery, you’ll receive anesthesia to numb your body and make sure you don’t feel any pain. An anesthesiologist will give you either general anesthesia to put you to sleep or a regional anesthesia to numb the area around your hip. They may give you other medications to make you sleep if you need regional anesthesia.

During a hip resurfacing, your surgeon will:

• Make incisions (cuts) in the skin around your hip.
• Remove damaged cartilage and bone from your hip socket.
• Insert the prosthetic acetabulum.
• Reshape and trim the top (head) of your femur so it fits into the new prosthetic socket. This is called resurfacing, and it’s where hip resurfacing gets its name.
• Put a cap on your femur. The cap is usually metal, but your surgeon might use a ceramic cap instead.
• Re-align your hip joint and insert your resurfaced femur into the prosthetic socket.

How long does hip resurfacing surgery take?

Hip resurfacing surgery usually takes two to three hours. It may take more or less time depending on how damaged your natural hip joint is and which kind of prosthetic your surgeon uses.

What happens after hip resurfacing?

After surgery, you’ll be moved to a recovery room. Your surgery team will keep an eye on you for a few hours to make sure you wake up from the anesthesia without complications. They’ll also monitor your vital signs and pain level.

Most hip resurfacing surgeries are outpatient procedures. That means you can go home the same day. Your surgical care team will perform a medical exam and physical therapy assessment before they say it’s safe for you to go home.

What are the benefits of hip resurfacing?

The most obvious benefit of hip resurfacing is how much it can improve your quality of life. People who have a successful hip resurfacing usually experience noticeably reduced pain, improved mobility and increased strength. You should be able to resume all of your favorite physical activities once you recover.

Other benefits of hip resurfacing can include:

• Increased mobility compared to hip replacements: Most people who get hip resurfacing can run, jump and do almost any physical activity after they heal. People who have hip replacements usually need to stick to low-impact activities like walking, swimming and golfing.
• Reduced risk of dislocation: Because hip resurfacing keeps some of your natural hip joint, it’s less likely to lead to hip dislocations than a fully prosthetic joint.
• Improved biomechanics: Hip resurfacing will let you move better and safer. This is especially true if you’ve changed how you move, run, jump or use your hip to compensate for pain and other symptoms.
• Lifelong symptom relief: A hip resurfacing usually lasts a long time. Many people who have hip resurfacing live with it for the rest of their lives.

What are the negatives or complications of hip resurfacing?

Hip resurfacing is usually a safe, effective procedure. But some risks are possible, including:

• Femoral neck fractures: Resurfacing the top of your femur can weaken the area below it (the neck). This can increase the risk that your femoral neck fractures (a broken femur). If you experience a broken femur, you’ll probably need a total hip replacement.
• Metal-on-metal ionization: If your surgeon uses a metal cap on your femur and a metal prosthetic acetabulum, there’s a small chance you experience metal-on-metal ionization. This happens when the two pieces of metal rub together over time. The extra friction can release negatively charged particles (ions) into your hip joint. The ions can damage the tissue in and around your hip and weaken your bones.

Hip resurfacing shares the same risks as any type of surgery. Rare complications include:

• Blood clots.
• Infection inside your hip or at your surgery site.
• Nerve damage.
• Blood vessel damage.
• Problems with the prosthetic implant, including the device wearing down too soon.
• Scar tissue inside your hip.

Your surgeon will tell you what you can expect after your surgery and how you can reduce your chances of experiencing complications.

What is the recovery time for hip resurfacing?

It usually takes a few months to recover completely after hip resurfacing surgery. Your surgeon will probably ask you to start moving and putting some weight on your hip right away, often as soon as the day after your surgery. You’ll likely need to use crutches or a walker for a few weeks.

Most people need at least a few weeks of physical therapy after hip resurfacing. A physical therapist will give you exercises to strengthen your hip muscles and regain your range of motion.

You should be able to resume everyday activities around six weeks after your surgery. Your surgeon will tell you when it’s safe to resume more intense physical activities like running, jumping or playing sports.

Ask your surgeon or physical therapist for tips on moving through your home safely after your surgery. They can show you how to:

• Walk and move.
• Sit down and stand up.
• Go to the bathroom.
• Bathe or shower.
• Get dressed.
• Use stairs.

When can I go back to work or school?

If you can do your job or schoolwork without putting a lot of physical strain on your hip, you might only need a week or two off.

If you have a more physically demanding job, or your studies require you to be on your feet or not sitting at a desk, you might need to take a longer break. Tell your surgeon about your daily routine, including all of your jobs, hobbies and physical activities. They’ll let you know what’s safe to do while you recover.

Pain management after hip resurfacing

After surgery, you’ll feel pain, especially in the first few weeks of your recovery. You’ll feel pain from the surgery itself and pain as your body begins to heal.

Your surgeon will suggest a combination of prescription pain medication, over-the-counter NSAIDs (if it’s safe for you to take them) and acetaminophen to relieve your pain. They’ll also tell you how much of each kind of medication you can take each day or in a certain amount of time.

When should I call my healthcare provider?

Call your surgeon or healthcare provider right away if you experience any of the following symptoms:

• Chest pain.
• Shortness of breath (dyspnea).
• Fever higher than 101 degrees Fahrenheit (39 degrees Celsius).
• Bleeding.
• Signs of an infection at your surgery site, including leaking, swelling, discoloration, odor or a feeling of warmth.
• New or worsening pain in your leg, calf, ankle or foot.
• Severe pain that doesn’t get better after you take pain medication.