Hip Resurfacing vs Hip Replacement: Know The Difference

Hip Resurfacing vs Hip Replacement: Know The Difference

Everybody knows about or have heard of total hip replacement. However, there are many people who have no idea what hip resurfacing surgery is and how it can possibly be used as a replacement for the total hip replacement.

However, that does not mean that every individual who has been recommended a total hip replacement can opt for this alternative. Hip resurfacing is a less invasive form of joint replacement surgery, which is advised to only selected individuals.

This article talks about some of the major differences between hip resurfacing and total hip replacement. Additionally, it also explores some of the possible advantages and disadvantages of hip resurfacing over hip replacement.

Similarities and Differences

what is hip resurfacing surgery

Both hip resurfacing and hip replacement intend to relieve pain arising out of the degenerative changes in the hip joint. Both of these can be advised to patients with osteoarthritis of the hip joint. The difference lies in the approach used to conduct the surgery and the procedure followed.

In conventional hip replacement surgery, the entire socket and the ball part of the hip joint are replaced with artificial implants. The implants could be either metal or ceramic implants or a combination of both.


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The ball is the top of the thigh bone called femur and it fits into the socket to form a joint. In total hip replacement surgery, the ball is completely removed and replaced with a prosthesis. The stemmed component of the implant is placed in the marrow cavity of the femur. The stemmed component has a ball at the top, which fits into the socket (also known as acetabulum). The entire ball-socket set-up then fits into the pelvis.

total hip replacement surgery

The set-up remains the same in the case of hip resurfacing as well, with a difference in the way how the thigh bone is addressed and treated. In hip resurfacing procedure, the ball on the top of the femur is not removed. Instead, it is shaved and to form a peg, which is then shaped or trimmed so that a metal ball can be placed around it. Therefore, the thigh bone is preserved in the case of hip resurfacing.

Benefits of Hip Resurfacing Surgery


  • Failed implants may be easier to replace in a revision surgery as it is less invasive. The femur placement is also necessary for this to take place.
  • Smooth metal covering creates a closer-to-natural shape of the femoral head, potentially decreasing risk for dislocation and achieving subtle advantages in a natural walking pattern.


  • A small fraction of patients may experience a break in the thighbone at the femoral neck. If this occurs, the patient usually requires a total hip replacement.
  • Over time, some patients may acquire sensitivity or an allergy to the metal particles produced by the metal ball and socket. If this occurs, the patient may experience pain and swelling.
  • A larger incision is typically necessary as hip resurfacing is more difficult than total hip replacements, which could result in a larger scar.

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Potential Advantages and Disadvantages of Hip Resurfacing vs Hip Replacement

Ease of Revision Surgery:

A revision surgery is easier and more successful in case it is conducted after hip resurfacing than hip replacement. This is because in the former case, the thigh bone is preserved and less bone is removed. Whereas in the case of hip replacement, the ball portion of the femur is completely removed and replaced with an implant. This results in a considerable bone loss, which makes revision surgery a tedious task to perform. There is not much bone left to fix another implant.

Thigh Bone Fracture

Because the individuals’ natural femoral head is retained during the hip resurfacing surgery, there are high chances of thigh-bone fracture. However, this is not the case with hip replacement. If a thigh-bone fracture occurs during hip resurfacing, the surgeons have no option but to continue with the total hip replacement procedure. But that does not mean that fractures cannot happen at all in the case of hip replacement. It can still occur around any of the implanted components.

Incision Size

Hip resurfacing is a bigger and more complicated procedure than hip replacement even though it results in less bone loss. This is because it requires manipulation of the femoral head to the placement of the metallic ball. This may require a bugger incision than hip replacement. Because it is more difficult and risky, many surgeons do not perform hip resurfacing.

Implant Type

For total hip replacement, there a wide variety of implants available. This includes metallic, polyethylene, and ceramic implants. However, hip resurfacing is only conducted with the help of metallic implants. Implant manufacturers around the world are currently working on ceramic implants for hip resurfacing.


Hip resurfacing lasts longer than a hip replacement for most of the patients. This procedure is particularly beneficial for young individuals. This is because in their case, they are expected to outlive the normal lifespan of the implants used in the case of total hip replacement.

Return to Normal Routine

People who undergo hip resurfacing are more likely to return to their normal routine and activities such as running, skiing, and other competitive sports. However, this is not true about people who undergo total hip replacement. Overall, people who undergo hip resurfacing live a more active and functional life than those who undergo total hip arthroplasty.

Risk of Dislocation and Inaccurate Leg Length

Because of the larger size of the ball in the case of hip resurfacing, there is a reduced risk of dislocation. A dislocation is characterized by the disengagement of the ball from the socket. Om the other hand, the risk of inaccurate leg length is more in total hip arthroplasty. Hip resurfacing ensures an equal length of both the legs because the natural bone (femur) is preserved in the patients.

Best Candidates For Hip Resurfacing Procedure

Not everyone is suitable for hip resurfacing procedure. For example, men are more likely to have a successful procedure than women. Also, people with osteoarthritis of the knee do better with hip resurfacing than those who have avascular necrosis.

Hip resurfacing is considered the best for younger men who live an active lifestyle and have average height. It has many benefits to offer as compared to total hip replacement. It can make people return to their normal and active lifestyle. However, only a surgeon is able to tell whether a hip resurfacing or total hip arthroplasty is what you need.

Last modified on at Oct 08, 2019

Guneet Bhatia

Guneet Bhatia is an avid reader, healthcare writer, and is currently Director of Patient Care Department, MediGence. She has also been featured on many prominent Healthcare portals such as IBTimes, HCIT Expert, Clinician Today.

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