What's The Difference Between Hip Resurfacing And A Hip Replacement

For athletes - especially athletes who play high-collision sports like hockey - osteoarthritis of the hip is all too common. But instead of correcting it with a hip replacement, many opt for hip resurfacing.

"Hip resurfacing is a bone-preserving alternative to a total hip replacement," says T. Sean Lynch, M.D., a sports medicine and orthopedic surgeon at Henry Ford Health. "It can be a great option for younger athletes who need to get back to a high level of activity."

With a total hip replacement, prosthetics are used to replace the entire hip joint: the ball, socket and femoral neck (or part of the thigh bone just below the ball). With hip resurfacing, a prosthetic only replaces the hip socket. It's called "resurfacing" because the ball is then shaped to fit into the prosthetic hip socket.\

Hip resurfacing also differs from a partial hip replacement: With a partial hip replacement, the ball of the hip joint is replaced (along with a bit of the femoral neck) but not the socket.

The Benefits & Risks Of Hip Resurfacing

Athletes often favor hip resurfacing because it may offer additional stability of the hip joint.

"People say it gives them a bit more mobility," says Dr. Lynch. "And if you need revision surgery when you're older, you have more bone to do that with. Sometimes younger athletes may need a hip replacement later in life, but resurfacing can be beneficial for athletes who will likely outlive their first hip replacement and who need a high range of motion from the hip joint."

There is, however, a downside to hip resurfacing - as some level of risk is associated with any surgery. "There's a chance that metal ions from the implant could build up around the hip joint and get into the blood," says Dr. Lynch. "If this happens, it could potentially damage organs. This is why we regularly monitor bloodwork afterward."

For older people who have osteoarthritis of the hip, Dr. Lynch often recommends a total hip replacement instead of hip resurfacing. "The technology for hip replacement is pretty good today - most of the general population do well with it," he says.

As for a partial hip replacement? "That's often used if the ball of the thigh bone is fractured. It's a great option for younger people who have had trauma to the hip."

Recovering From Hip Resurfacing Surgery

Recovery from hip resurfacing surgery is slower than recovery from a total hip replacement - at least initially. "Since we keep the femoral neck, there's a risk for fracture if you return to a sport too soon," says Dr. Lynch. "We want to limit the amount of weight you put on your leg. It takes somewhere between four to six months to get back to a high level of activity."

Once you're recovered, hip resurfacing may provide a cure - at least for several years. "In time, if you end up developing further arthritis of the socket, or if the implant fails, you'll need to consider converting to a total hip replacement," says Dr. Lynch. "But that usually won't be for years down the line. Before then, you're good to go."

Reviewed by T. Sean Lynch, M.D., a sports medicine and orthopedic surgeon who sees patients at the Henry Ford Center for Athletic Medicine and Henry Ford Medical Center-Plymouth.