Severe hip pain can make it difficult to walk, sit, or even rest comfortably. For patients with hip pain that does not improve after several months, your doctor may recommend hip surgery if non-surgical treatments aren’t effective at improving your symptoms.

There are two main types of hip surgery: hip resurfacing and hip replacement. Both are effective, long-lasting treatments for hip pain, but the right procedure for you will depend on your condition, the cause of your pain, and your age. 

Florida Medical Clinic Orlando Health orthopedic surgeon Dr. Stephen Raterman explains the difference between hip resurfacing vs hip replacement and who is typically a good candidate for each. 

Reasons for Hip Surgery

The hip is one of the most important joints in the body. Our hips give us the ability to bend, walk, sit, and perform many other basic movements. But the cartilage and bones that make up the hip joint can degrade over time, often because of a physical injury or a degenerative illness like osteoarthritis.

Your doctor may recommend surgery if:

• It’s hard for you to go up and down the stairs, get in and out of chairs, or get up from bed
• You have difficulty walking because of pain, pain at night which interferes with sleep
• Your pain and stiffness don’t improve with physical therapy or pain medication
• Your hip or upper thigh bone is fractured

Hip Resurfacing

Hip resurfacing involves smoothing down damaged cartilage and bone and placing a metal cap over the bone to reduce friction when moving. Orthopedic surgeons often recommend hip resurfacing for patients who:

• Are under 60
• Are active in physical sports or exercise
• Have larger frames, and this precludes women due to the availability of sizes as well as healthy bones

Hip resurfacing is not suitable for certain patients with specific underlying health conditions—including patients with metal allergies, those who are at high risk of future fractures, and those with significant bone density loss due to inflammatory arthritis.

Outcomes of Hip Resurfacing

Patients who receive hip resurfacing often enjoy significantly less pain and more mobility than before the procedure. Many are able to return to the recreational  high impact sports and exercises that they enjoyed previously. Patients who have a hip replacement and a hip resurfacing prefer the hip resurfacing side for higher demand activities and claims it feels more natural.

Hip resurfacing is often recommended for younger patients because it’s more suited for active lifestyles—but, like a full replacement, the surgical metal used in resurfacing will wear out over time. That means hip resurfacing usually requires a revision surgery 15 to 20 years after the initial procedure.

Furthermore, patients who undergo hip resurfacing have a small risk for developing a femoral neck fracture, which is a fracture that occurs in the area that connects the ball of the hip joint to the rest of the hip. If this happens, your orthopedic surgeon may recommend you undergo a total hip replacement to treat it.

Hip Replacement

Hip replacement (or hip arthroplasty) is a surgery that removes all of the ball and socket of your hip joint with a prosthetic. When compared to resurfacing, hip replacement is best for patients who:

• Are over 60 years of age
• Have extensive bone loss as a result of osteoarthritis
• Don’t participate in high-impact activities
• Are allergic to the metal used in resurfacing (there are ceramic options for replacement implants)
• Have an anatomical problem that might exclude them from resurfacing, such as a large leg length difference

Outcomes of Hip Replacement

Like resurfacing, hip replacement can greatly improve pain and mobility—and make everyday tasks possible once more.

However, even if hip replacement makes it easier to get around the house, patients shouldn’t participate in certain activities, such as running, basketball, or soccer.

It’s also important to avoid movements like crossing your legs or bending more than 90-degrees at the waist if you have a posterior approach, however, Dr. Raterman has performed thousands of minimally invasive anterior approach for hip replacements. This improves the early recovery and minimizes the dislocation risk of the posterior approach. There is no need for restrictions in sleeping, leg crossing, or the height of your chairs.  Since the anterior hip replacement patients have no internal muscular releases, the early recovery is faster and the usual dislocation precautions do not apply.

Finally, hip replacements may require future revision surgery. New developments in replacement technology mean that many hip replacement implants last up to 20 years or even longer. Some patients may require an earlier revision in cases of infection or injury that compromises the stability of the joint.

Deciding Which Procedure Is Right For You

The best way to decide which procedure is right for you is to talk with a doctor who specializes in hip reconstruction.

An orthopedic surgeon can help you weigh the benefits and potential drawbacks of each surgery, as well as take into account your personal health situation. A surgeon will look at the reason for your pain, ask about your medical history, and use imaging tests (like x-rays and MRIs) to see if you qualify for surgery.

Your doctor will also discuss which specific surgery is best for you. To sum it all up:

• Hip resurfacing is often better for younger patients who are more active in sports and exercise and who don’t have an underlying condition that might disqualify them from resurfacing.
• Hip replacement is typically geared toward older patients who are less active or patients who don’t qualify for hip resurfacing because of a health condition.

Both procedures also come with risks typically associated with any operation, including blood clots, nerve damage, and infection. Your doctor will fully discuss all risks with you to help you make a decision that’s best for your health.

Talk with a Tampa Hip Surgeon

Advances in medical technology have made hip surgery, both replacement and resurfacing procedures, safer and more effective than ever before. If your hip pain is getting in the way of your everyday activities, you may be a good candidate for surgery. 

An expert in minimally invasive hip surgeries, Dr. Stephen Raterman has helped countless patients in the Tampa Bay area regain their mobility and get back to living a pain-free life. To learn more, schedule an appointment with Dr. Raterman at a Florida Medical Clinic Orlando Health location in North Tampa, Zephyrhills, or Wiregrass. Virtual telemedicine appointments are also available. 

About Stephen Raterman, MD, FACS

Dr. Stephen Raterman is a board-certified orthopedic surgeon and an expert in joint replacements and hip resurfacing procedures. 

In addition to seeing patients, Dr. Raterman also teaches as a Clinical Associate Professor of Orthopedics at the University of South Florida.

Disclaimer: This blog is not intended to substitute professional medical advice. Every patient is different, so talk with your orthopedic doctor to learn what treatment options are best for you.