Harvard Health Letter

Choices for hipsters

Several types of hip replacements are available, and hip resurfacing has made a comeback.

The total hip replacement has become one of the most common and most successful operations performed in the United States, and perhaps the world. Over 200,000 hip replacements are performed on Americans each year, a number that may almost triple over the next couple of decades as baby boomers get older and their hips creakier. With this popularity has come choice in everything from the type of incisions (minimally invasive vs. conventional) to the material used in the new hip (metal, polyethylene, ceramic) to how the parts of the new hip are attached to the leftover bone.

Recently, a modified version of the total hip replacement has made a comeback, so there's another item on the hip-repair menu. Hip resurfacing, as it is called, preserves the neck and head of the thighbone, or femur. The operation is being promoted as an option for younger patients who might otherwise be told to hold off on getting the traditional hip replacement operation till they are in their mid-60s or older. There are questions, though, about whether hip resurfacing is being oversold. And, as is often the case with new surgical procedures, large, well-designed randomized trials are lacking. Patients and doctors have only scraps of evidence to go on.

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