Introduction

Hip resurfacing is becoming a popular alternative to traditional total hip replacement for people looking to relieve hip pain and regain mobility. This treatment preserves more of your natural bone and can be especially appealing if you want to stay active. However, not everyone is a suitable candidate. Factors like your age, activity level, and personal goals play a vital role. In this article, we’ll explore how doctors decide who is best suited for hip resurfacing, the assessment process, and which patients tend to benefit most.

What Is Hip Resurfacing?

Hip resurfacing involves covering the femoral head—the “ball” of the hip joint—with a smooth metal cap, unlike total hip replacement where the entire ball and neck are replaced. This bone-preserving method can help maintain more natural hip movement and makes future surgeries easier if necessary. Generally, it’s recommended for people under 60, but active older adults with strong bones may also be suitable.

As pointed out by Gaillard and colleagues (2017), “THA, when compared with hip resurfacing arthroplasty, removes substantially more bone-stock, limits range-of-motion, exhibits increased dislocation risk, and presents greater overall 10-year mortality rate.” Important factors include bone health (sometimes called “hip resurfacing bone quality”), physical activity, and overall health, which influence whether hip resurfacing could be right for you.

Who Is a Good Candidate?

Deciding if hip resurfacing is suitable starts with a detailed medical review, imaging scans, and assessments of bone density. Typically, people under 60 are considered the best candidates, though some older adults with excellent bone quality and a desire to stay active might also benefit. Poor bone health—like osteoporosis—usually rules out resurfacing because it raises the risk of complications.

Doctors also look at what matters most to you. Whether you want to return to sport, manage daily activities, or simply enjoy pain-free movement, your goals help shape the decision. Interestingly, recent research shows that, with improved surgical techniques, “women show promise as excellent candidates for hip resurfacing as an alternative treatment for their debilitating hip conditions” (Gaillard et al., 2017).

Comparing Hip Resurfacing and Hip Replacement

It’s important to understand the differences between hip resurfacing and total hip replacement before making a decision. Resurfacing usually means a quicker recovery and may allow you to maintain a higher activity level, which is why younger, active patients often prefer it. Meanwhile, total hip replacement might be more suitable if you are older or have weaker bones or other health issues.

A recent comprehensive study found that “HRA demonstrated lower infection and dislocation rates compared to standard THA. HRA also offers a shorter operative time” (Riché et al., 2025). However, the same research showed “no difference was observed for functional outcome between the three techniques,” indicating that your personal health and lifestyle are crucial factors in choosing the best procedure.

Furthermore, new evidence indicates hip resurfacing may be a valuable option even for older adults. Wong and colleagues (2025) found that “in carefully selected patients aged 65 years or older, HRA can provide comparable or superior outcomes to THA.” They also noted that “HRA patients demonstrated significantly higher scores for hip function and activity levels at 1-year and final follow-ups.” Still, they stress that “the decision should be individualized, considering patient factors and potential risks” (Wong et al., 2025).

Finally, advances in technique mean that previous disparities—such as higher failure rates in women—are reducing, making resurfacing more accessible and effective than before (Gaillard et al., 2017).

The Klinik Perspective: Expertise and Patient Care

At our clinic, we pride ourselves on a patient-centred approach consistent with the latest professional guidelines. For some cases, such as trauma or cancer-related fractures, we may use bone cement to optimise recovery. For most other patients, we achieve excellent results with uncemented implants.

Professor Paul Lee, an expert in orthopaedics and cartilage, leads our team. His extensive experience and roles, including Regional Surgical Ambassador and advisor to the Royal College of Surgeons of Edinburgh, ensure that care at MSK Doctors meets the highest standards. Our multidisciplinary team supports you throughout your journey—from initial assessment to full recovery—providing expert, personalised treatment every step of the way.

Conclusion

Hip resurfacing can offer great benefits for many patients—particularly those under 60 or active older adults with strong bones and clear goals to maintain activity. A thorough assessment is essential to ensure it is the right choice for you.

If you’re considering hip resurfacing, speak openly with your orthopaedic surgeon. Discuss your lifestyle, health, and expectations to make an informed decision suited to your needs. With expert guidance, you can choose the best path to enjoying improved hip function and quality of life.

References

• Gaillard, E. B., Gaillard, M. D., & Gross, T. (2017). Interventions for improving hip resurfacing outcomes in women: A high-volume, retrospective study. Journal of Arthroplasty. https://doi.org/10.1016/j.arth.2017.06.003
• Riché, L., Baccon, N., Girard, J., Migaud, H., & Bouché, P. (2025). Hip resurfacing arthroplasty reduces dislocation and infection rates without differences in clinical outcomes compared to short and standard stems: A network meta-analysis. Orthopaedics & Traumatology: Surgery & Research. https://doi.org/10.1016/j.otsr.2025.104239
• Wong, Z., Saluja, A., Jordan, L. A., Spaan, J., & Su, E. (2025). Total hip arthroplasty vs hip resurfacing in patients over 65: A propensity score–matched comparison of patient-reported outcomes. Arthroplasty Today. https://doi.org/10.1016/j.artd.2025.101721