Everything you need to know about hip resurfacing surgery

Hip resurfacing surgery is hugely successful at restoring hip function and reducing discomfort, allowing you to get back to the lifestyle and exercise you enjoy.

However, any kind of surgery can be daunting. Here, King Edward VII Hospital Orthopaedic Surgeon, Mr Jamie Griffiths, explains what hip resurfacing surgery involves, what you may expect from your recovery and some practical tips for ensuring your recovery goes as smoothly as possible.

What is hip resurfacing surgery?

Hip resurfacing surgery is a surgical procedure that involves reshaping the hip joint to allow for more freedom of movement and less pain and discomfort.

The hip is a type of “ball and socket” joint. Hip resurfacing surgery typically involves removing the surface of the “ball” (the rounded upper tip of the thigh bone, or femur) and of the “socket” (the acetabulum, part of the pelvic bone) within the hip joint.

The two surfaces are then resurfaced with a metal covering to create a metal-on-metal bearing surface that’s smooth and durable.

It’s ideally suited to younger, more active patients with stronger bones to allow for a return to a higher level of activity.

Hip resurfacing differs from a total hip replacement during which the hip joint is replaced entirely with a prosthesis.

If appropriate the potential advantages of a hip resurfacing over a total hip replacement include:

• It may not wear out as quickly as a total hip replacement
• It offers perhaps a better range of motion
• Its less likely to dislocate compared to a total hip replacement

Who is suitable for hip resurfacing?

Hip resurfacing surgery is best suited to younger male patients wishing to return to a higher level of physical activity. It’s not often performed on female patients due to a higher risk of a metal-on-metal reaction.

This kind of surgery is usually offered to those with hip pain that’s affecting their day to day life and/or their ability to exercise, and who struggle with hip pain during the night.

Your age, weight, smoking status and general all round health will also be taken into account by your surgeon. Hip resurfacing typically doesn’t work well in those with brittle bones. Therefore if you take steroids or have, or are at risk of, osteoporosis or weakened bones, this will also be taken into consideration.

What happens on the day of hip resurfacing surgery?

You will be asked to refrain from eating food for a minimum of six hours prior to your surgery. You can continue to drink water. Your surgeon and anaesthetist will review you before you’re taken down to surgery – your anaesthetist will discuss your anaesthesia with you, usually it will be either a spinal or a general anaesthetic.

Hip resurfacing surgery typically takes around an hour, and you’ll spend some time in recovery before being taken back to the ward. During the procedure, your surgeon will “block” the hip with a local anaesthetic block.

Along with the regional anaesthetic (if used), this block will act to make you more comfortable in the immediate hours following your surgery.

A few hours after surgery, the local anaesthetic will wear off, and it’s therefore important that you take painkillers following surgery so that you have a good baseline level of pain relief for when the anaesthesia wears off. Your nursing team will provide you with the pain relief you need.

Mr Griffiths has a specialist interest in enhanced recovery with the aim of early mobilisation, typically within hours following your surgery. This will help to manage your pain and optimise your overall function while reducing your overall risks of complications.

Therefore you will be helped out of bed onto your feet and be fully weight bearing with crutches for confidence, either the same day or the next morning following your surgery.

How long is the recovery following hip resurfacing?

Every patient is different, and your own recovery will depend on your personal circumstances, including your activity levels and level of health and fitness prior to surgery.

However, the majority of patients will have recovered enough to go about their normal daily activities and return to work after six weeks. It will take up to 12 weeks to fully return to sports and exercise.

Is recovery quicker than having a hip replacement?

No, hip resurfacing is a different surgical procedure to a total hip replacement – but the recovery periods are the same.

What activities should I avoid after hip resurfacing surgery?

You should aim to be as weight bearing as possible, but you should avoid strenuous and repetitive impact sports that involve running, jumping and twisting for 12 weeks.

Your medical team will give you advice and support on getting in and out of bed, standing and walking with crutches.

How long will I need off work?

Hip resurfacing surgery normally requires patients to have six weeks off work. However, this will depend on the type of work that you do.

Some people who can work from home may be able to return to work sooner. It may take those who have physically demanding jobs a little longer to return to their normal work duties.

How soon after hip resurfacing surgery can I drive?

Ultimately, you will know when you feel confident enough to drive, but you must be able to perform an emergency stop. This is usually around three to four weeks following surgery.

It may help to drive with another driver in the car for your first few trips out, so that they can take over if you lose confidence.

Find out more about going on holiday after hip surgery.

When can I get back to exercise?

Most patients can return to gentle exercise within six to 12 weeks of hip resurfacing surgery. You should avoid repetitive impact exercises such as running or playing tennis for at least 12 weeks.

Your surgical team can guide you, depending on your rate of recovery and your level of fitness.

How long does hip resurfacing last? Can I have it more than once?

Providing that your surgery goes well, and your recovery is straightforward, hip resurfacing can last indefinitely.

A resurfaced hip could arguably experience less wear and tear than a hip prosthesis fitted during a total hip replacement.

This is because it has a more durable bearing surface that enables a successful return to sport, and doesn’t carry the risk of accelerated wear as would be seen in an active, young male patient who has a total hip replacement.

Why do professional sportspeople require hip resurfacing surgery?

Young people that play sports competitively and professionally can benefit from hip resurfacing surgery if they’re experiencing hip pain and immobility. This is due to the high success rate of this type of surgery for getting back to playing sports at a professional level.

Also, the larger femoral head as a result of hip resurfacing permits a better range of motion and a lower dislocation rate than a total hip replacement.

More information:

• If you’re experiencing hip pain, speak to your GP about your options, including the possibility of hip resurfacing surgery. (Don’t have a GP?)
•  The King Edward VII Hospital is a world-renowned centre of excellence for orthopaedic surgery. Make an appointment.