Hip Replacement vs Hip Resurfacing: Pros, Cons, and Who’s Best Suited for Each

Medicine Made Simple

Hip replacement and hip resurfacing are two surgical options to treat severe hip problems. Both aim to relieve pain and improve mobility, but they differ in how much of the hip joint is replaced, the recovery process, and who they are best suited for. In this blog, we explain the difference in simple terms, highlight the pros and cons of each, and guide you on how doctors decide which surgery is right for you.

Understanding Hip Replacement

In a total hip replacement (THR), both the ball (head of the femur) and the socket (part of the pelvis) are removed and replaced with artificial implants. These implants are usually made of a combination of metal, ceramic, and plastic.

This surgery is commonly recommended for patients with advanced arthritis, fractures, or avascular necrosis. It is one of the most successful orthopedic surgeries and can last 15–20 years or more.

Understanding Hip Resurfacing

Hip resurfacing is different. Instead of removing the entire ball of the femur, the damaged surface of the ball is trimmed and capped with a smooth metal covering. The socket is also lined with a metal cup.

Because more of the natural bone is preserved, hip resurfacing is often considered for younger, more active patients.

Pros of Hip Replacement

• Works well for patients of all ages, including elderly patients.
• Long track record of safety and excellent outcomes.
• Wide choice of implant materials (ceramic, metal, plastic) to suit individual needs.
• Suitable for patients with severe bone loss or deformity.

Cons of Hip Replacement

• Removal of more bone compared to resurfacing.
• Implants may wear out and require revision surgery after 15–20 years.
• Activity restrictions are usually advised to protect the implant.
• Slightly longer recovery in some cases compared to resurfacing.

Pros of Hip Resurfacing

• Preserves more of the patient’s natural bone.
• Larger ball size, which may reduce risk of dislocation.
• Patients may return to higher levels of activity, including sports.
• Easier revision surgery in the future, if needed, compared to hip replacement.

Cons of Hip Resurfacing

• Not suitable for elderly patients with weaker bones or osteoporosis.
• Higher risk of femoral neck fracture (a break in the bone under the resurfaced cap).
• Metal-on-metal implants may release metal ions, which can cause complications.
• Less commonly performed, so fewer surgeons specialize in it.

Who Is Best Suited for Each?

Hip replacement is generally better for:

1. Patients over 60 years old.
2. People with advanced arthritis or bone loss.
3. Those with weaker bones due to osteoporosis.

Hip resurfacing may be considered for:

1. Younger patients (usually under 55).
2. Active individuals who want to return to sports or heavy physical work.
3. Patients with strong, healthy bone structure.

How Doctors Decide

The decision is based on several factors:

• Age and activity level of the patient.
• The strength and quality of the bone.
• Type and severity of hip disease.
• Risks of complications such as fractures or metal ion problems.

Ultimately, the surgeon will recommend the procedure that offers the best balance of pain relief, mobility, and long-term safety.

Life After Each Surgery

After a total hip replacement, most patients return to daily activities within 4–6 weeks and can enjoy long-lasting relief from pain. However, high-impact activities like running or jumping are usually discouraged.

After hip resurfacing, recovery may be slightly quicker for some patients, and they may be able to return to higher-impact activities. But long-term outcomes depend heavily on patient selection and surgical expertise.

Conclusion

If you are struggling with hip pain and are unsure whether hip replacement or resurfacing is right for you, consult an experienced orthopedic surgeon. A proper evaluation of your age, lifestyle, and bone health will help determine the best option. Taking the right decision early can help you regain mobility and enjoy life without hip pain.

References
American Academy of Orthopaedic Surgeons. Hip Resurfacing
Mayo Clinic. Hip Replacement Surgery
NHS UK. Hip replacement

*Information contained in this article is not intended or designed to be a substitute for professional medical advice, diagnosis, or treatment. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other professional health care provider with any questions you may have regarding a medical condition or advice in relation thereto.