Hip Resurfacing: Who It's For, How It Works, and What Recovery Looks Like
Updated: 6 days ago
Written and medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026 · How we review
Quick Answer: What is hip resurfacing?
Hip resurfacing is a hip surgery that replaces only the hip socket with a prosthetic and trims and caps the head of the thigh bone instead of removing it. It treats severe arthritis pain and stiffness that nonsurgical care has not relieved, and it best suits people under 60 with strong, healthy bones. Most people go home the same day. [1]
What the research says
Resurfacing matches total hip replacement on function, with fewer dislocations. A meta-analysis of 8 randomized trials (844 patients, mean follow-up 7.7 years) found no significant difference in function scores, revision, infection or loosening, while dislocation was significantly lower after resurfacing. (Za et al., International Orthopaedics, 2024) [2]
Active patients return to high-level activity more often. A systematic review of 27 studies (4,182 patients) found similar fracture and infection rates to total hip replacement, lower dislocation rates, higher activity scores and better restoration of natural hip mechanics after resurfacing. (Hellman et al., The Bone & Joint Journal, 2019) [3]
Patient selection drives long-term results. In a national registry of 5,068 resurfacings, 10-year implant survival was 86% versus 92% for the comparison hip replacements, and women had about twice the revision risk of men. (Seppänen et al., Acta Orthopaedica, 2016) [4]
Key takeaways
Hip resurfacing replaces the hip socket and reshapes and caps the femoral head, keeping more of your natural bone than a total hip replacement. [1]
Osteoarthritis is the most common reason for the surgery. [1]
The best candidates are usually under 60, physically active and have strong, healthy, larger bones. [1]
Surgery takes about 2 to 3 hours, and most people go home the same day. [1]
Everyday activities usually resume at about 6 weeks; full recovery takes a few months. [1]
The two main specific risks are a femoral neck fracture and metal ion release from metal-on-metal parts. [1]
What is hip resurfacing surgery?
Hip resurfacing is a surgery that repairs damage inside the hip joint by replacing less of the joint than a standard hip replacement. Doctors also call it hip resurfacing arthroplasty. [1]
The surgeon replaces only the hip socket (acetabulum) with a prosthetic piece. They then trim and reshape the head of the thigh bone (femur) so it fits securely into the new socket. [1]
That reshaping step is the "resurfacing" that gives the operation its name. [1]
What does hip resurfacing treat?
Hip resurfacing treats severe hip symptoms that do not improve with nonsurgical care such as activity changes, physical therapy or medication. [1]
Symptoms that can lead to the surgery include: [1]
Hip pain
Stiffness or reduced range of motion
Limited mobility, such as difficulty walking
Swelling
Instability, or not feeling steady on the hip
Arthritis is the most common reason people need hip resurfacing. Most have osteoarthritis, and some people with rheumatoid arthritis may need it too. [1]
How is hip resurfacing different from a total hip replacement?
Hip resurfacing differs from a total hip replacement mainly in how much natural bone it keeps: resurfacing caps the femoral head, while a total replacement removes it. [1]
Feature | Hip resurfacing | Total hip replacement |
Hip socket | Replaced with a prosthetic | Replaced with a prosthetic |
Femoral head | Trimmed, reshaped and capped | Removed |
Natural bone kept | More | Less |
Bone health needed | Higher — the femur must be strong enough to resurface | Less of a factor |
Activity after healing | Most can run, jump and do almost any activity | Usually low-impact activities such as walking, swimming and golf |
Dislocation risk | Lower | Higher |
Source: [1]
Who is a good candidate for hip resurfacing?
Good candidates for hip resurfacing are usually younger than 60, physically active and have strong, healthy bones. [1]
Bone health matters more here than in a total hip replacement. Because the surgeon keeps part of the natural joint, the femur must be strong enough to be resurfaced. [1]
Bone size is also important. Men typically have larger bones than women, so they are more often suited to the surgery, but bone size matters more than sex. [1]
Your surgeon will recommend the type of hip surgery that best fits your body, needs and situation. [1]
How do you prepare for hip resurfacing?
Preparing for hip resurfacing usually involves health checks and imaging so your care team can confirm surgery is safe for you. [1]
You might need: [1]
A physical exam
Blood tests
An electrocardiogram (ECG) to check your heart
A dental exam to lower your infection risk after surgery
A hip X-ray, and sometimes an MRI or CT scan
Tell your care team about every medication and over-the-counter supplement you take, because you may need to stop some before surgery. [1]
Most people stop eating and drinking about 8 hours before surgery. Your surgeon will tell you which medications are safe to take with a sip of water that morning. [1]
What happens during hip resurfacing surgery?
During hip resurfacing, the surgeon replaces the hip socket and caps the reshaped femoral head while you are under anesthesia. [1]
An anesthesiologist gives either general anesthesia, which puts you to sleep, or regional anesthesia, which numbs the area around your hip. You may also receive medication to help you sleep with regional anesthesia. [1]
The surgeon then: [1]
Makes incisions in the skin around the hip.
Removes damaged cartilage and bone from the hip socket.
Inserts the prosthetic socket (acetabulum).
Trims and reshapes the femoral head to fit the new socket.
Places a cap on the femur — usually metal, sometimes ceramic.
Realigns the joint and fits the resurfaced femur into the new socket.
How long does hip resurfacing surgery take?
Hip resurfacing surgery usually takes 2 to 3 hours. The exact time depends on how damaged the joint is and which prosthetic the surgeon uses. [1]
What happens right after hip resurfacing?
Right after hip resurfacing, you move to a recovery room where the team watches you for a few hours as the anesthesia wears off and checks your vital signs and pain level. [1]
Most hip resurfacing surgeries are outpatient procedures, so you can usually go home the same day. Before you leave, the team performs a medical exam and a physical therapy assessment. [1]
What are the benefits of hip resurfacing?
The main benefit of hip resurfacing is a better quality of life, with noticeably less pain, better mobility and more strength after a successful operation. [1]
Other benefits include: [1]
More mobility than a hip replacement: most people can run, jump and do almost any physical activity once healed.
Lower dislocation risk: keeping part of the natural joint makes hip dislocation less likely than with a fully prosthetic joint.
Better biomechanics: you can move more safely, especially if you changed how you walk or run to cope with pain.
Long-lasting relief: many people live with their resurfaced hip for the rest of their lives.
What are the risks of hip resurfacing?
Hip resurfacing is usually safe and effective, but its two specific risks are a femoral neck fracture and metal ion release. [1]
Risk | What happens | Why it matters |
Femoral neck fracture | Reshaping the femoral head can weaken the bone just below it (the neck). | A broken femur usually means converting to a total hip replacement. |
Metal-on-metal ionization | A metal cap rubbing on a metal socket can release ions into the joint over time. | The ions can damage tissue around the hip and weaken bone. |
Source: [1]
Rare complications shared with other surgeries include: [1]
Infection inside the hip or at the incision
Nerve damage
Blood vessel damage
Implant problems, including early wear
Scar tissue inside the hip
Your surgeon will explain how to lower your chance of complications. [1]
How long is the recovery after hip resurfacing?
Full recovery after hip resurfacing usually takes a few months, with everyday activities resuming at about 6 weeks. [1]
Time after surgery | What to expect |
Day of surgery | Recovery-room monitoring; most people go home the same day |
From day 1 | Start moving and putting some weight on the hip |
First few weeks | Crutches or a walker, plus at least a few weeks of physical therapy |
About 6 weeks | Return to most everyday activities |
A few months | Full recovery; your surgeon clears running, jumping and sports |
Source: [1]
A physical therapist will give you exercises to strengthen your hip muscles and regain range of motion. [1]
Ask your surgeon or therapist how to safely walk, sit and stand, use the bathroom, bathe, get dressed and use stairs at home. [1]
When can you go back to work after hip resurfacing?
You may need only 1 to 2 weeks off work or school after hip resurfacing if your tasks put little strain on your hip. [1]
Physically demanding jobs, or studies that keep you on your feet, usually need a longer break. Tell your surgeon about your work, hobbies and activities so they can advise what is safe. [1]
How is pain managed after hip resurfacing?
Pain after hip resurfacing is managed with a combination of prescription pain medication, over-the-counter NSAIDs when they are safe for you, and acetaminophen. [1]
Pain is strongest in the first few weeks, from both the surgery and healing. Your surgeon will tell you how much of each medication you can take and how often. [1]
When should you call your doctor after hip resurfacing?
Call your surgeon right away after hip resurfacing if you notice any of these warning signs: [1]
Chest pain
Shortness of breath
Fever above 38.3 °C (101 °F)
Bleeding
Signs of infection at the incision: leaking, swelling, discoloration, odor or warmth
New or worsening pain in the leg, calf, ankle or foot
Severe pain that does not improve with pain medication
For a closer look at clot warning signs, read our guide to deep vein thrombosis.
Hip resurfacing at a glance
Item | Detail |
Also called | Hip resurfacing arthroplasty |
Main reason | Osteoarthritis (sometimes rheumatoid arthritis) |
Typical candidate | Under 60, active, strong and larger bones |
Anesthesia | General or regional |
Operation time | About 2–3 hours |
Hospital stay | Usually same-day discharge |
Walking aids | Crutches or walker for a few weeks |
Everyday activities | About 6 weeks |
Full recovery | A few months |
Key specific risks | Femoral neck fracture; metal ion release |
Source: [1]
Conclusion
Hip resurfacing offers a bone-saving alternative to total hip replacement for the right patient: usually someone under 60, active and with strong, healthy bones. It replaces the socket, caps the reshaped femoral head, and lets most people return to running, jumping and sport once healed. [1]
The trade-offs are real, including a risk of femoral neck fracture and metal ion release, so the decision belongs in a detailed conversation with an orthopedic surgeon who can assess your bone quality and goals.
Living with hip pain or stiffness? Bring this guide to your next orthopedic appointment and ask whether hip resurfacing or a total hip replacement fits you better. Then keep learning with our guides to hip arthritis, hip impingement and hip labral tears.
FAQ
What is the difference between hip resurfacing and hip replacement?
Hip resurfacing replaces the hip socket and caps the reshaped femoral head, while a total hip replacement removes the femoral head and replaces it with an artificial ball and stem. Resurfacing keeps more of your natural bone.
Who is a good candidate for hip resurfacing?
Good candidates for hip resurfacing are usually younger than 60, physically active and have strong, healthy bones. Bone size also matters, which is why men are more often suited than women, though bone size counts more than sex.
How long does hip resurfacing surgery take?
Hip resurfacing surgery usually takes 2 to 3 hours. The time depends on how damaged the joint is and which prosthetic the surgeon uses.
Is hip resurfacing an outpatient surgery?
Hip resurfacing is usually an outpatient surgery, so most people go home the same day. The care team first completes a medical exam and a physical therapy assessment.
How long is recovery from hip resurfacing?
Recovery from hip resurfacing usually takes a few months in total. Most people use crutches or a walker for a few weeks and return to everyday activities at about 6 weeks.
Can you run after hip resurfacing?
Most people can run, jump and do almost any physical activity after hip resurfacing once they have healed. Your surgeon will tell you when it is safe to start high-impact activity.
What are the risks of hip resurfacing?
The specific risks of hip resurfacing are a femoral neck fracture and metal ion release from metal-on-metal parts. Rare general risks include blood clots, infection, nerve or blood vessel damage, implant wear and scar tissue.
When should I call my doctor after hip resurfacing?
Call your surgeon right away after hip resurfacing for chest pain, shortness of breath, fever above 38.3 °C (101 °F), bleeding or signs of wound infection. New leg, calf, ankle or foot pain, or severe pain that medication does not relieve, also needs prompt attention.
Can hip resurfacing release metal into the body?
Yes. Metal-on-metal parts can release tiny metal particles called ions, which is one of the main risks of hip resurfacing. Your surgeon will explain how your implant will be checked over time.
Is hip resurfacing a good choice for women?
It can be, but registry data show women have about twice the risk of needing a repeat operation compared with men. Surgeons look at bone strength, joint size and activity level when deciding who is a good candidate.
Related Reading
Hip Replacement Surgery: Procedure, Recovery Time and Risks explains how a total hip replacement works and what recovery involves.
Hip Arthritis: Understanding Symptoms, Causes, and Modern Treatments covers the symptoms, causes and treatment options for hip arthritis.
Avascular Necrosis (Osteonecrosis): Symptoms, Causes, Diagnosis & Treatment — Complete Guide explains how loss of blood supply damages bone in the hip.
Hip Revision Surgery: Why It's Done, What Happens, and How Recovery Works explains when and how a worn or failed hip implant is replaced.
References
Cleveland Clinic. Hip Resurfacing: What It Is, Procedure & Recovery. Cleveland Clinic. Last updated September 25, 2024. https://my.clevelandclinic.org/health/treatments/17103-hip-resurfacing
Za P, Casciaro C, Papalia GF, et al. Hip resurfacing versus total hip arthroplasty: a systematic review and meta-analysis of randomized clinical trials. International Orthopaedics. 2024;48(10):2589-2601. PMID 39107628. https://doi.org/10.1007/s00264-024-06269-3
Hellman MD, Ford MC, Barrack RL. Is there evidence to support an indication for surface replacement arthroplasty?: a systematic review. The Bone & Joint Journal. 2019;101-B(1 Suppl A):32-40. PMID 30648490. https://doi.org/10.1302/0301-620X.101B1.BJJ-2018-0508.R1
Seppänen M, Karvonen M, Virolainen P, et al. Poor 10-year survivorship of hip resurfacing arthroplasty. Acta Orthopaedica. 2016;87(6):554-559. PMID 27759474. https://doi.org/10.1080/17453674.2016.1246316
Disclaimer
This article is for educational purposes only and does not replace professional medical advice, diagnosis or treatment. Always talk with a qualified healthcare provider about your symptoms and treatment options. If you have chest pain, trouble breathing or another emergency, call your local emergency number right away.
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