Harvard Health Letter

Easier way to help your hip?

Choose wisely when considering surgical options.

When it's time to do something about the unbearable arthritis pain in your hip, you'll likely hear about an alternative to total hip replacement called hip resurfacing. The two procedures appear to have similar short-term results with regard to function and activity level, according to a new study in the journal BMJ. But be careful. "The long-term benefits haven't been shown at all," says Dr. Donald Reilly, assistant clinical professor of orthopedic surgery at Harvard Medical School.

Hip Replacement

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Hip Resurfacing

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Replacement vs. resurfacing

The hip is a ball-and-socket joint, where the thigh bone (femur) meets the pelvis bone. The ball is at the top of the femur, known as the femoral head, below which is the neck of the femur. The socket is the acetabulum, part of the pelvis bone. In a total hip replacement, the surgeon removes the damaged surface of the socket, the femoral head, and the neck of the femur, then replaces them with prosthetic components. In a hip resurfacing, the surgeon places a prosthetic cap on the femoral head, preserving the neck, and replaces the acetabulum. Resurfacing preserves the femur, which may make future hip surgeries easier. Insurance pays for both procedures and recovery time is the same: three days in the hospital, followed by 4–6 weeks of physical therapy.

In the study published in BMJ, researchers found no difference in hip function one year after study subjects underwent either a hip replacement or a hip resurfacing. Dr. Reilly says that doesn't tell us much. "Other studies show that after two years there's a higher failure rate in resurfacing—femoral neck fracture and loosening." Dr. Reilly says that 90% of total hip replacements are functioning well after 15 years.

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