Hip Resurfacing for Younger, Active Adults With Arthritis
Is hip resurfacing a good alternative to hip replacement?
Hip resurfacing is an arthritis surgery that caps the ball of the femur instead of removing it, and lines the socket with an implant. It saves more of your own bone than a total hip replacement. It suits a narrower group: younger, active patients, usually men under 60 with a large femoral head and strong bone.
In a total hip replacement, the ball of the femur and part of the neck are removed and replaced with a stem. Hip resurfacing takes a different route: the ball is reshaped and capped, and most of the thigh bone stays intact. For a narrow group of active patients, that bone-saving design is appealing. For many others, a total hip is the safer choice, and Dr. Stride will tell you which group you are in.
Written and medically reviewed by Dr. Stride, MD, board-certified orthopedic surgeonLast reviewed October 2026
At a glance
- Also called
- hip resurfacing arthroplasty, Birmingham-style resurfacing, bone-sparing hip replacement, hip cap surgery
- Typical recovery
- Yearly
- Category
- Hip Replacement
Is this right for you?
Usually a good fit if
- Hip arthritis in an active adult, typically under 60
- A larger femoral head and strong, healthy bone
- Men are more often good candidates, since bone size matters
- Patients who want to return to demanding activities and understand the trade-offs
Another option may be better if
- Weak bone, osteoporosis or large cysts in the femoral head
- Small femoral heads, which is more common in women and raises the risk of problems
- Kidney disease or metal sensitivity concerns when a metal-on-metal design would be used
What happens, step by step
A candid candidacy review
Dr. Stride measures the femoral head size on X-ray, checks bone quality and reviews your activity goals. He walks through the specific risks of resurfacing, including femoral neck fracture and metal ion concerns with metal-on-metal bearings, side by side with total hip replacement.
Capping the ball
Through an incision at the hip, the damaged cartilage on the ball is trimmed and shaped to accept a smooth cap. The thigh bone canal is left largely untouched.
Lining the socket
A matching shell is pressed into the prepared socket. The cap and shell are checked for fit, motion and stability.
Up the same day
Most patients stand and walk with support the same day or the next morning.
Typical recovery timeline
Walking with crutches or a walker, protecting the femoral neck while bone adapts. Home exercises several times a day.
Gradual move to a cane or no support. Desk work usually returns within a couple of weeks if the job is not physically demanding.
Most everyday activities, driving and longer walks are back.
Cycling, swimming, the gym and golf. Higher-impact activity is discussed individually.
Follow-up visits with X-rays, and blood metal ion checks when a metal-on-metal bearing was used.
Timelines are typical ranges. Your plan depends on your hip, your health and what was done in surgery.
“Resurfacing is a good operation in a narrow lane. If you are a big-boned, active guy in your 40s or 50s, it is worth a real conversation. If you are not in that lane, I will steer you toward a total hip, because that is the better hip for you.”
Dr. Stride, MD
Frequently asked questions
What is the difference between hip resurfacing and hip replacement?
Hip resurfacing keeps the femoral head and neck and caps the ball, while total hip replacement removes the ball and places a stem in the thigh bone. Both line the socket. Resurfacing saves more bone but suits fewer patients.
Why is hip resurfacing not recommended for women?
Hip resurfacing outcomes depend heavily on the size of the femoral head, and women on average have smaller hip bones. Bone size matters more than sex itself, so some women with larger femoral heads may still be candidates.
What are the risks of hip resurfacing?
Specific risks include a fracture of the femoral neck and, with metal-on-metal designs, wear particles that can irritate surrounding tissue. Standard surgical risks like infection and blood clots also apply.
Can a hip resurfacing be converted to a total hip later?
Yes, because resurfacing preserves the thigh bone, converting to a total hip replacement is usually possible if problems develop later.
Related treatments
Total Hip Replacement
Total hip replacement replaces the worn ball and socket of an arthritic hip with a metal, ceramic and medical-grade plastic implant.
Read more →ReplacementAnterior Hip Replacement
Anterior hip replacement is a total hip replacement performed through an incision at the front of the hip, working between muscles instead of detaching them.
Read more →ReplacementRevision Hip Replacement
Revision hip replacement is a surgery that removes and replaces some or all parts of a previous hip replacement.
Read more →DiagnosisHip X-ray & MRI
Hip X-rays and MRI answer different questions.
Read more →Questions patients ask about this
After a Hip Replacement, Can You Run, Golf or Play Pickleball?
Some people do run after a hip replacement, but it is a personal decision to make with your surgeon.
Do I Need a Hip Replacement? Signs It Is Time
You may be ready for a hip replacement when arthritis pain limits walking, sleep and daily activities, and non-surgical treatments such as therapy, medicine and injections no longer give enough relief.
How Long Does a Hip Replacement Last?
Most hip replacements last 20 years or more.
SourcesReferences used for this page2
Medically reviewed by Dr. Stride, MD against current guidance from these sources. Last reviewed October 2026. How we write and review content
- Hip Resurfacing (opens in a new tab) AAOS OrthoInfo
- Hip Resurfacing: What It Is, Procedure & Recovery (opens in a new tab) Cleveland Clinic