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Hip Resurfacing: Better Than Hip Replacement?

By Lisa Collier Cool | Posted October 14 2010

Beth Barney was only 21 when her doctor advised hip replacement surgery due to joint damage triggered by a birth defect called congenital hip dysplasia. “The pain was getting progressively worse and kept me up at night,” recalls the Neuvo, California stay-at-home mom. “I couldn’t exercise or walk more than one block. Going to the grocery store was difficult and I had a very noticeable limp.”

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But the treatment sounded scary, adds Barney. “The doctor said that because I was so young, the surgery might have to be redone two or three times as I got older and I might end up in a wheelchair.” She searched online and found another option: a less invasive, bone-conserving treatment called hip resurfacing. The procedure involves resurfacing the head of the femur (thighbone) instead of amputating it, as in total hip replacement, in which the bone is replaced with a metal or ceramic ball attached to a long stem that’s inserted into the remaining bone.

In September, 2000, Barney consulted Harlan Amstutz, MD, founding director of the Joint Replacement Institute at St. Vincent Medical Center in Los Angeles, who developed the Conserve Plus Total Resurfacing Hip System. At the time, it was experimental. In November, 2009, the device was FDA-approved to relieve hip pain and improve function in people with arthritis and other joint diseases.

It’s designed for young or middle-aged patients with an active lifestyle, who are likely to outlive the normal 15-to-20 year lifespan of a total hip replacement implant, says Dr. Amstutz, who has treated more than 1,300 patients from teenagers to seniors with his technique. “The big advantage of resurfacing are that it preserves bone, making it easier to do revision surgery if it’s ever needed, since the femoral head and neck aren’t cut off.  It also mimics the natural shape of the femur and hip socket, preserving full range of motion.”

In a clinical trial of the Conserve Plus, 93.6 percent of the patients studied had excellent or good hip function 24 months later. For Barney, who had the surgery ten years ago, the device has transformed her life. “As soon as I woke up from the anesthesia, the pain in my hip was gone. Now I can chase my kids around and play with them—after being told that I might not be able to care for children at all.” In August, the now 32-year-old mom gave birth to her fifth child with no pregnancy or hip complications.

Last year, she put her hip implant to the test by competing in a triathlon. She finished first in her age group (and seventh overall) by finishing the 800-yard swim, 12-mile bike ride, and 5K run in 97 minutes. “It was exhilarating to do well,” says Barney. “Hip resurfacing has been a blessing because the most active years of my life were ahead of me.”

CONNECT THE DOTS

To learn more about the Conserve Plus Total Hip Resurfacing System or find a doctor who offers this technique, visit the site of its manufacturer, Wright Medical Technology. The Joint Replacement Institute has studies and background on resurfacing. The Mayo Clinic has a report comparing hip resurfacing and hip replacement. There are several types of artificial hip joints to relieve pain and restoring movement. If you’re considering joint surgery, discuss potential risks and benefits with your doctor.

  • john mastroianni

    I am a paitent of a resurfacing hip called teh corun hip. My surgeon advised me that I should never run and also wanted me always to park close to the destination I was going to so I could preserve the hip implant. He told me 7 to 8 years of use. This article that you are writing is not representative of medical managment of hip impants especially resurfacing.

  • Stephan Russo

    Question — I am considering having hip resurfacing surgery. My doctor says I am a good candidate for this procedure and is recommending it. I am a 59 year old male and very active. I swim close to a mile 3-4 times/week and still play lacrosse competitively (in my age group). How long can I expect the resurfacing procedure to last in comparison to a hip replacement and when would I expect to be fully active again after the surgery?

  • nadine

    Is it true that some surgeons are no longer performing resurfacing on wmn due to neg reactions?

  • Kim

    I was wondering if Beth Barney had metal on metal resurfacing and then had children after?? I am a 37 year old, who needs hip surgery and I was told I can’t have any more children after my hip resurfacing. If I decide to have more children I have to have THR, instead of a resurfacing. Very confused..

  • Lisa Collier Cool

    Hi Kim,

    Beth’s five kids were all born after she had the hip resurfacing at age 21. If you’d like to see a photo of Beth with two of her adorable kids and read more about the procedure, check out this article in the Saturday Evening Post on hip resurfacing: http://www.saturdayeveningpost.com/2010/10/13/wellness/medical-update/hip-resurfacing.html
    The FDA has further details about the Conserve Plus device:
    http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DeviceApprovalsandClearances/Recently-ApprovedDevices/ucm191091.htm

  • Beth Barney

    Hi Kim,
    I had this procedure done not only to alleviate the pain but because I wanted to have a family and be a mom. Like Lisa said I had all five children post surgery. I had no pain or complications during pregnancy and plan to have one more child. There have been no negative effects from the metal implant on my children. I don’t know why you were told you couldn’t have children after resurfacing. A THR is much more invasive anyway and you are so young that resurfacing would make sense for you. To answer the other question, I was back in the pool teaching water aerobics 8 weeks after surgery. I’m sure recovery time would vary with each person but that is how long it took for me. Good luck with everything and if you would like to talk more let me know and I can give you my number.

  • Paul

    I recently had fusion on my lower back, but am told that I need hip replacement or resurfacing?? My sister in law had her hip surgury done in India. She was 59 when she had it done 3 years ago after seeing her Dr. from India on television. Please advise!

  • Ruth Franklin

    I’m 83 years old. I have been told I need Hip replacement.I’m wondering how I will benfit from it or get a weel chair? I have the most unconfort in my left thigh when I sit I get stiff as I move my wal get better. Trying to decide.

  • Pete Bocko

    I am 57 now, and had bilateral hip resurfacing a little over the year ago and as I told my doctor I wish all my joints were in as good a shape as the hips. I am surprised at the first comment’s doctors limitations. I followed the advice explicitly for the first year. With doctors approval I am jogging again, training classic Olympic weightlifting and power lifting moves. My only limitations is not to flex hips & knees over 90 degrees under load and don’t lift more than 300#. Of course, the particular type of hip replacement depends upon your doctors evaluation, but hip resurfacing has really worked well for me and is growing in popularity.

  • Lisa Collier Cool

    Pete,

    Glad to hear that hip resurfacing has worked out so well for you and that like Beth Barney, you’re leading a very active lifestyle. Thanks for weighing in about my post!

  • Lisa Collier Cool

    Dear Joan,

    You can contact Dr. Amstutz through the Joint Replacement Institute at St. Vincent Hospital in Los Angeles, CA, of which he is the founding director. The JRI also has more information about hip resurfacing on its website: http://www.jri-docs.com/Pages/default.aspx. To find other doctors who perform hip resurfacing with the Conserve Plus system discussed in the post, use this link: http://www.wmt.com/PhysLocator/PhysLoc.asp?CODE=1008

  • nanci spivak

    I am a 58 y/o female active,fit sl under weight mut good tone and mri reveal some sort of “growth” inside the femoral shaft ALONG with need for hip replacement vs resurfacing. does anyone know a dr. here in the louisville area who excells at the latter. thank you for any info

  • Lisa Collier Cool

    To find doctors who perform hip resurfacing with the Conserve Plus system discussed in the post, use this link: http://www.wmt.com/PhysLocator/PhysLoc.asp?CODE=1008
    You enter your location and a list of doctors in your area will be emailed to you. In addition, for more options, the American Board of Orthopaedic Surgery offers an orthopedic specialist finder by city, state or zip code: https://www.abos.org/ModDefault.aspx?module=Public&section=PubFind&Print=1.

  • Lisa Collier Cool

    Dear Ruth,

    As you try to decide which treatment would be best, I encourage you to partner with your doctor in weighing the risk and benefits of both options. If you’re still undecided, consider seeking second opinion, which I have found useful when making decisions about my own healthcare. Good luck with finding the right therapy for your condition.

  • Lisa Collier Cool

    Hi Paul,

    You may be interested in our blog post about medical tourism, since you mention the possibility of being treated in India:
    http://www.healthymagination.com/blog/the-medical-tourism-boom-2/

  • Lwcollier

    After hip resurfacing, one of my relatives, who is quite athletic, was able to continue with his karate–he’s a black belt and practices every morning.

  • Lisa Collier Cool

    Like Pete who is jogging and doing weightlifting again, a relative of mine in his 60s has returned to his favorite type of exercise, karate, after getting hip resurfacing. He is very healthy and fit, but no longer competes in marathons as he did in younger days before developing hip problems.

  • Stephen Wolfram

    My orthopedic surgeon wants me get a cortisone shot for my significantly arthritic hip due to a surfing accident 22 years ago. He wants to delay hip surgery as long as possible since he says I’m “only 44 years old”. I don’t want a cortisone shot AND it appears from my research that a hip resurfacing is exactly the treatment that would help a younger patient who wants to remain active surfing and practicing yoga. Should I be looking for another surgeon?

  • Shriya

    Dear Beth,

    Good to learn from you of post-operation status of hip resurfacing after 10 years.

    I am also an bitaleral AVN patient. suffering since 1997.

    I had Core-decompression operation on both by hips, but it lasted for 6 years and again pain started.

    Then I started with homeopathy. There was a good result having homeopathy treatment.

    But my both hips started worsening after by first normal delivery on 17 Jan 2009.

    And now the pain is so acute, that I & my husband thought of going for Hip Resurfacing.

    I am much worried about this operation having several things in mind. Regarding the mobility of my legs and weight bearing, restriction etc also how many year will this long last.

    If I can get your contact number will be great help to me. want to have detail talk about this operation.

    Thank you in advance for all your help and time extended to me.

    Regards,

    Shriya.

  • Lisa Collier Cool

    Shrlya,

    I will contact Beth by email and pass along your contact info since I don’t know if she’s continuing to follow the comments here, but has been very generous with sharing her experiences to help others.

  • Carmine Huber

    I was told I need a new hip, my mind and heart say no. I am active and this would hold me back. My Dr. had said he couldn’t see anything wrong. After a second opinion he changed his mind. My reg. Dr. doen not think I need a new hip and is having me get MRI and x-rays done. Do you think I should look into the proceedure of resurfacing? Thank you.

  • Lisa Collier Cool

    Hi Carmine,

    Since the 2 doctors don’t agree, I suggest seeking a third opinion and wish you every success in finding the best treatment.

  • Dan

    I have worked as a professional firefighter for 22 years with a THR on my right side. The hip is secondary to steroid treatment and now surgery is required on my left hip which I will be having within the next few months. The option of resurfacing was never given to me and I am looking for a Dr. in the New Orleans area which can assist. Please direct me if possible. I will travel if I have to.

  • Ursula

    My son is 22 and in Oct. 2010 was diagnosed with AVN. Approximately 505 of his hip joint is dead. Would he be a candidate for hip resurfacing? His orthopedic doctor is worried about replacing his hip because of his age. He is willing to consider it because he is in constant and increasing pain, can’t work steadily or go to school. Seeing this sight and posts has given me a little hope.

  • Steve

    I must admit I am very nervous. I am scheduled to have the resurfacing procedure on April 6th. I am a basketball official and my concerns are, although I should be able to get my quality of life back (i.e. putting on a shoe and sock, sleeping at night, sitting on a toilet) that I won’t be able to officiate at the level I have been accustomed to for the past 10 years. I have had 3 Dr.’s tell me I am the perfect candidate for this type of procedure (33yrs old) and will feel better then I have in 10 years. But, I am still very nervous. Thank you for sharing your story.

  • Lisa Collier Cool

    Dan,

    To look for a doctor in your area who does hip resurfacing with the Conserve Plus system discussed in the post, use this link: http://www.wmt.com/PhysLocator/PhysLoc.asp?CODE=1008.

  • Lisa Collier Cool

    Ursula,

    What a shame that your 22 year old son is dealing with AVN. I think it’s always a good idea when dealing a serious disorder to get a second opinion and if necessary, a third opinion if the first 2 doctors don’t agree, on possible treatments and wish your son every success in finding the best therapy for his condition.

  • Smartkathy Green

    Hi..your blog is very interesting and helpful. If You are Thinking of Having a Hip Replacement…I am here to help. There’s not much for me to update on my own progress.

    I would like to recommend you one best hip replacement surgeons- Dr. Zehr, an orthopedic surgeon at Zehr center who specializes in hip and knee arthritis surgery.

    For more information please visit: http://www.zehrcenter.com/practice/total-hip-replacement

  • Dr.Dinesh

    @ ursula have u been advised stem cell therapy?

  • TNGrits

    I had my 1st Smith Nephew Birmingham Hip Resurfacing System to my right hip done 4 years ago at age 59 (-3 days) and it has been wonderful. Immediate pain relief, worked hard at physical therapy and was virtually fully recovered at 6 weeks. Some pain from the stem for months, but it eventually dissipated. Last year I fell and suffered an intertrochanteric fracture on the left side and had emergency surgery to repair. On March 25 at age 63 I had my 2nd BHR to the left hip which included removing hardware from prior year’s surgery. I’m now having physical therapy and expect full recovery. Highly recommend – just be sure you have a very experienced orthopedic surgeon. I volunteer in dog rescue and will return to this activity as soon as possible.

  • Kwok

    Like many I am confronted with the options of THReplacement or THResurfacing. I am leaning towards the latter because of my age, 38 and still wish to pursue an active lifestyle.

    My orthopedic doc actually called me (knowing that I called in to cancel the appointment with him in favor of going for the THresurfacing. He told me that he knew all my concerns (age, active lifestyle) but he reinstated that THresuracing is not reliable and it may last shorter a period that I would have wish for before resorting to a THreplacement. He said that he would advise against his relative or closed ones against THresuracing.

    These 2 docs seem good but each has their own conviction. Help!

  • ihsan

    I had the Conserve Plus put in back in at the end of 2001 by Dr. Ed Sparling in Vancouver, Washington. I was a 23 year old soldier, wrestler, and martial artist. Here it is, 10 years later, and I’m still a wrestler, martial artist, and a federal civilian employee (law enforcement.) The resurfacing truly saved me from a wheelchair. I refused every other treatment offered and dealt with my osteoarthritic hip for three years until I found this procedure. I have done everything from boxing, Muay Thai, wrestling, Brazilian Jiu Jitsu, tackling non compliant suspects, running, hopping fences, chasing children, and house work without pain and with full range of motion. If you are a candidate, DO THIS SURGERY.

  • Tina

    Beth:
    Thank you so much for sharing your story and progress. Our 16 year-old son was involved in an accident and has been dealing with pain, decreased range of motion, etc. He has been given two options for treatment, hip fusion & hip resurfacing. We are not comfortable with the idea of a hip fusion and are leaning toward a resurfacing. He is about 1 1/2 years out from his initial injury and ready to get back to some of the activities that he enjoyed prior to the accident. Your blog gave him hope that there may be light at the end of the tunnel. Thank you again!

  • Caroline MacKinnon

    Hi to all in America. I am now 48 years old and had a hip resurfacing, metal on metal 11 years ago, my other hip was resurfaced 2 years ago however, due to it loosenung I am due to have a THR in 2 weeks. My surgeon has suggested that if one resurfacing is revised to THR then the other is usually converted to THR shortly after. Does anyone have any info. on this.Thank you.

  • nadine

    I am very athletic, personal trainer and former triathlete, one problem I have had that is haunting me is a leg length discrepancy after my resurfacing surgery and as a result ongoing pain in my si joint, I can’t run or swim , any kind of spinal extension is very painful. I’d like to know if anyone else has had this experience. I do wear a lift in my shoe but this has not solved the problem.

  • The McMinn Centre

    The Birmingham Hip Resurfacing (FDA Approved) is one of, if not the most successful hip resurfacing device. It was designed in by surgeons in Birmingham, UK. Derek McMinn one of the designer surgeons, who continues to operate and use the device, has an outstanding success rate of 97% at 13 years with the device.

    Ofcourse hip resurfacing is better than a replacement as anything which can conserve bone and prolong the ammount of time a patient can remain mobile is a good thing. If you have a hip resurfacing and it needs revising after 10, 15 or even 20 years then you’ve had an extended period of not having the full hip replacement which you otherwise would not have had.

    Derek McMinn is an renowned surgeon and treats patients from the world over. His patients can run marathons, climb mountians, cycle, swim, play tennis, golf or almost any other sport.

    There is no reason why after having a Birmingham Hip Resurfacing from Derek McMinn that you shouldnt be leading a very active and fulfilling lifestyle.

  • Amy Carpenter

    I am coming up on my 2 year anniversary of Birmingham Hip resurfacing on my right hip by Dr. Patrick Morgan (U of Mn-Fairview Riverside Hospital) in Mpls, Mn. I was in tremendous pain prior to surgery, but now walk 4-5 miles or bike 15 miles almost every day with no pain. Even if I have to have total hip replacement down the line, these two years were well worth the risks of surgery. I am so grateful to Dr. Morgan for giving me my life back!

  • Laurie

    I had hip resurfacing about 6 months ago. That leg is longer now, having trouble adjusting to that. Anyone out there having same problem? Any advise as to what i can do to help adjust better.

  • Hip Surgeries Florida

    This is really a great idea. Liked the information shared. Appreciative blog!

  • michele

    Laurie, I had the surgery too. My doctor says the leg is not really longer. It is that every layer of the soft tissues are swollen preventing you from putting your full weight on the leg so that its gets seated in all the way in the socket. In time everything should level out. Good luck.

  • michele

    Nadine,
    I had similar issues (SI joint was stuck after surgery) and finally found a total movement therapist. He performed a lot of deep soft tissue work, stretching and strengthening of my total lower body from ankles to lower back. I felt better in 4 weeks with him than I did with 4 months of regular PT. He showed how the whole body is connected and was affected by the hip surgery. So eventhough the left side was cut, the muscles reaction went through the lower back to the right hip down the right quad. The muscle work was painful but I am finally getting mobiliy without pain.

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