Hip Surgery

Hip Resurfacing

Hip resurfacing is a bone-preserving alternative to total hip replacement. Instead of removing the femoral head and replacing it with a stem, resurfacing caps the femoral head with a metal covering and places a metal cup in the acetabulum. This preserves bone stock for potential future revision and is designed for younger, active patients with good bone quality.

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On This Page

Recovery

Return to high-impact activities; bone preserved for future revision if needed.

Clinical Focus

Femoral head preservation, metal-on-metal bearing, bone stock conservation, designed for active patients.

Ideal Candidate

Younger, active patients (typically men under 60) with severe hip arthritis and good bone quality.

Understanding Your Procedure

In-Depth: Hip Resurfacing

A clear, comprehensive look at what this procedure is, how it works, and why it may be the right choice for you.

is fundamentally different from . In , the is removed and replaced with a metal ball on a stem inserted into the . In resurfacing, the is trimmed and capped with a metal covering (a resurfacing component), preserving the bone of the and neck. A metal cup is placed in the , creating a metal-on-metal bearing surface.The primary advantage of resurfacing is bone preservation. Because the and neck are retained, if the resurfacing ever needs to be revised, the conversion to a is typically simpler than revising a total hip, as the femoral canal has never been reamed for a stem. This makes resurfacing attractive for younger patients who may outlive their first .However, resurfacing is only appropriate for a narrow patient population. It requires good bone quality (typically confirmed in younger, active males), specific anatomy, and carries unique risks including femoral neck fracture and concerns about metal ion levels from the metal-on-metal bearing. Dr. Sobh carefully evaluates each candidate to determine if resurfacing offers clear benefits over for their specific situation.

Hip Resurfacing — illustrated overview of the surgical approach and implant placement.

20-30+

Years Implant Lifespan

90%+

Patient Satisfaction

24h

Walking Post-Op

<1%

Complication Rate

What Makes This Approach Different

Femoral Head Preservation

The and neck are preserved, not removed. This conserves bone stock for potential future revision, which is simpler than revising a stemmed total hip.

Metal-on-Metal Bearing

The resurfacing uses a metal cap on the and a metal cup in the , creating a hard-on-hard bearing surface that is very durable for active patients.

Designed for Active Patients

Resurfacing is specifically designed for younger, active patients who want to return to high-impact activities and may outlive a traditional .

Anatomical Femoral Loading

Because the femoral neck is preserved, forces are transferred through the bone in a natural pattern, potentially reducing stress shielding that can occur with stemmed implants.

Clinical information reviewed and edited by Dr. Ali H. Sobh, MD, board-certified orthopedic surgeon. Content synthesized from peer-reviewed orthopedic literature, American Academy of Orthopaedic Surgeons (AAOS) guidelines, and Dr. Sobh's fellowship training at Rush University Medical Center. Last updated 2025.

Watch & Learn

Understanding Hip Resurfacing

These medically accurate videos explain how hip resurfacing differs from total hip replacement — preserving the femoral neck and capping the bone rather than removing it, making it ideal for younger, active patients.

Physician Guide9:31 min

Birmingham Hip Resurfacing — Complete Guide

Dr. Jason Brockwell explains how hip arthritis is diagnosed, how Birmingham Hip Resurfacing (BHR) differs from total hip replacement, and why resurfacing preserves bone for younger patients. Covers the BHR implant design developed in the 1990s.

Source: Asia Medical Specialists — Dr. Jason Brockwell

Live Surgery9:59 min

BHR Surgery — Inventor Derek McMinn

Watch Derek McMinn — inventor of the Birmingham Hip Resurfacing (BHR) — perform the procedure he pioneered. This surgical video shows the precise bone preparation and metal cap placement that defines hip resurfacing surgery.

Source: Derek McMinn — BHR Inventor

Dr. Sobh's Hip Resurfacing Expertise

Dr. Sobh evaluates each patient's candidacy for hip resurfacing carefully. This bone-preserving procedure is ideal for younger, active patients with good bone quality who may need a future revision. Dr. Sobh will discuss whether resurfacing or replacement is best for your situation.

Videos embedded from YouTube for patient educational purposes. Dr. Dr. Ali H. Sobh, MD reviews all educational content on this page. Sources: Asia Medical Specialists (Dr. Jason Brockwell) and Derek McMinn (BHR Inventor).

Interactive Education

See How Your Joint Works

Understanding your condition is the first step toward confident decisions. Use this interactive visualizer to explore the anatomy of the hip joint, compare a healthy joint with an arthritic one, and see exactly what hip resurfacing restores.

1
Toggle states to compare healthy, arthritic, and post-surgical joints.
2
Tap the dots to learn about each anatomical structure.
3
Watch the motion to see how the joint moves during activity.

Interactive Joint Visualizer

Explore how hip resurfacing works

For Education

Front View

100%

Tap the dots to explore the joint anatomy

Arthritic / Damaged

Illustration for educational purposes. Not a diagnostic image.

Recognizing the Signs

Common Symptoms

Many patients live with joint pain for years before seeking treatment. If you recognize several of these symptoms, it may be time to schedule a consultation.

When to seek care

If your symptoms interfere with sleep, work, or activities you enjoy, or if conservative treatments no longer provide relief, a surgical consultation is appropriate.

Hip pain in younger patients (typically under 60) that limits sports and high-impact activities

Stiffness and reduced hip range of motion

Desire to preserve bone for potential future revision

Pain that has not responded to conservative treatments

Good bone quality confirmed on X-rays

Dr. Ali H. Sobh, MD

Board Certified & Fellowship-Trained Orthopedic Surgeon

Rush University Medical Center Fellowship

Hour Detroit Top Doc Award 2025

900+ 5-Star Google Reviews

Why Dr. Sobh for This Procedure

Fellowship-Trained Expertise in Hip Resurfacing

Dr. Sobh's fellowship training included as part of his comprehensive adult reconstruction education. He carefully evaluates candidacy for resurfacing, which is appropriate for a narrow patient population—typically younger, active males with good bone quality and no significant deformity. He uses the Birmingham (BHR) system, the most studied and validated resurfacing with long-term registry data. His expertise in patient selection ensures that resurfacing is only recommended when it offers clear advantages over for the individual patient.

Meet Dr. Sobh Patient Testimonials

Conditions Treated

Is Hip Resurfacing Right for You?

Dr. Sobh may recommend this procedure for patients diagnosed with the following conditions.

Severe hip osteoarthritis in young, active patientsAvascular necrosis with preserved femoral headPost-traumatic hip arthritisDysplasia with secondary arthritis in suitable candidates

A thorough consultation and imaging review will confirm the best treatment path for your specific situation.

Are You a Candidate?

Candidacy for Hip Resurfacing

Dr. Sobh carefully evaluates each patient to determine if this procedure is the right fit. Here's a general guide — your individual consultation will provide a definitive answer.

Good Candidate

Younger, active patients (typically men under 60) with severe hip arthritis, good bone quality, and normal femoral head anatomy confirmed on X-rays.

Good Candidate

Patients who want to preserve bone stock for potential future revision and return to high-impact activities.

May Not Be a Candidate

Women of childbearing age are generally not candidates due to unknown effects of metal ions on fetal development. Patients with poor bone quality, small femoral heads, or significant femoral head deformity (e.g., from advanced AVN) are not candidates.

May Not Be a Candidate

Patients with metal sensitivity, kidney disease (which affects metal ion clearance), or inflammatory arthritis are typically not candidates for metal-on-metal resurfacing.

Technology & Techniques

Advanced Technology Used in Your Surgery

Dr. Sobh uses these specialized tools and technologies to ensure the highest level of precision and safety during your procedure.

Birmingham Hip Resurfacing (BHR)

The most studied and validated hip resurfacing system, with long-term registry data supporting its use in appropriately selected patients.

Metal-on-Metal Bearing

Cobalt-chromium cap and cup create a durable hard-on-hard bearing surface designed for active patients.

Cementless Fixation

Both the resurfacing cap and acetabular cup achieve biological fixation through bone ingrowth, eliminating the need for cement.

How the Surgery Works

Understanding Your Surgical Journey

From your first consultation to full recovery, here's what to expect at each stage. Dr. Sobh and the team at Michigan Orthopaedic Surgeons will guide you through every step.

Candidacy Evaluation

Dr. Sobh carefully evaluates bone quality, anatomy, and patient factors to determine if resurfacing is appropriate. This is only recommended for a narrow patient population.

Femoral Head Resurfacing

The is trimmed and capped with a metal resurfacing component, preserving the femoral neck and bone stock. A metal cup is placed in the .

Metal-on-Metal Bearing

The metal cap and metal cup create a durable bearing surface designed for active patients who want to return to high-impact activities.

Recovery & Activity Return

Recovery is similar to . Once healed, patients can return to high-impact activities that are typically discouraged after .

Recovery Timeline

Your Path Back to Activity

Recovery timelines vary by individual and procedure complexity. Dr. Sobh will provide a personalized rehabilitation plan. Here's a general guide to what most patients experience.

0-24 hours

Day of Surgery

Stand and walk with assistance. Pain managed with multimodal protocol. Most patients go home within 24-48 hours.

1-2 weeks

Early Recovery

Walk with a walker or cane. Physical therapy focuses on gait and hip stability. Incision heals.

2-6 weeks

Progressive Activity

Transition off walking aids. Resume driving and office work. Therapy advances to strengthening.

6-12 weeks

Full Recovery

Return to sports, including high-impact activities. Bone preservation allows future revision if needed.

Comparing Your Options

Hip Resurfacing vs. Alternatives

Understanding how hip resurfacing compares to other treatment options helps you make an informed decision. Dr. Sobh will discuss all viable options during your consultation.

Total Hip Replacement

Total hip removes the and replaces it with a stem. Resurfacing caps the , preserving bone. Total hip is appropriate for all patient types; resurfacing is only for a narrow population (young, active males with good bone).

Direct Anterior Hip Replacement

The anterior approach is a surgical approach to . Resurfacing is a different procedure entirely that preserves the . The two are not interchangeable—resurfacing is chosen for bone preservation, the anterior approach for muscle preservation.

Hip Arthroscopy

Arthroscopy addresses labral tears, impingement, or loose bodies but cannot reverse arthritis. Resurfacing is a definitive treatment for severe arthritis that replaces the joint surfaces.

Patient Journey Tip

Hip resurfacing is specifically designed for younger, active patients who may outlive a traditional implant. If you're considering resurfacing, be prepared for a thorough evaluation of your bone quality, femoral head anatomy, and activity goals. Not everyone is a candidate—Dr. Sobh will give you an honest assessment.

Benefits

This procedure offers significant advantages for qualified patients:

Preserves femoral head and bone stock
Easier revision to total hip if needed
Designed for younger, active patients
Allows return to high-impact activities
Anatomical femoral loading
Durable metal-on-metal bearing

Potential Risks

As with any surgery, there are potential risks. Dr. Sobh takes extensive measures to minimize them:

Femoral neck fracture (unique to resurfacing, ~1-2%)
Metal ion concerns (cobalt/chromium levels)
Not suitable for women of childbearing age
Narrow candidacy criteria
Implant loosening over time
Anesthesia-related risks

Important

This information is for educational purposes only. Your individual risks depend on your health history. Dr. Sobh will discuss your specific risk profile during your consultation.

Patient Questions

Frequently Asked Questions

Common questions patients ask about hip resurfacing.

Am I a candidate for hip resurfacing?

is appropriate for a narrow patient population: typically younger, active males under 60 with good bone quality and normal anatomy. Dr. Sobh will evaluate your X-rays, bone quality, and activity goals to determine if resurfacing is right for you.

Why isn't hip resurfacing recommended for everyone?

Resurfacing carries unique risks (femoral neck fracture, metal ion concerns) and requires good bone quality and specific anatomy. It is not suitable for women of childbearing age, patients with poor bone quality, or those with inflammatory arthritis. is appropriate for a much broader patient population.

Can I return to running and high-impact sports after resurfacing?

Yes. One of the advantages of resurfacing is that it is designed for active patients who want to return to high-impact activities. However, you should wait until full healing (typically 3-6 months) and discuss specific activity goals with Dr. Sobh.

What happens if the resurfacing wears out?

If resurfacing ever needs revision, the conversion to is typically simpler than revising a stemmed total hip, because the femoral canal has never been reamed. This bone preservation is one of the key advantages of resurfacing for younger patients.

Medically ReviewedLast reviewed: August 14, 2026

Dr. Ali H. Sobh, MD

Board Certified & Fellowship-Trained Orthopedic Surgeon — Minimally-Invasive Hip & Knee Replacement Specialist

This procedure page was clinically reviewed and approved by Dr. Ali H. Sobh, MD, a board-certified, fellowship-trained orthopedic surgeon specializing in direct anterior hip replacement and MAKO robotic knee surgery. Dr. Sobh graduated with high honors from Wayne State University School of Medicine and completed his adult reconstruction fellowship at Rush University Medical Center in Chicago. He practices at Michigan Orthopaedic Surgeons (MOS) with offices in Royal Oak and Southfield, Michigan.

View Full Credentials Editorial Standards

This information is for educational purposes only and is not a substitute for professional medical advice. Individual results and recovery timelines vary. Schedule a consultation with Dr. Sobh to discuss your specific condition and treatment options.

Happy, active patients enjoying life after orthopedic surgery recovery with Dr. Ali H. Sobh

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Ready to Take the Next Step?

Schedule a personalized consultation with Dr. Sobh to discuss whether hip resurfacing is right for you. Our team will help coordinate your visit, insurance verification, and pre-operative planning.

Book an Appointment Call (833) 667-3627