In May 2026, the Royal Orthopaedic Hospital in Birmingham published the story of Fria, the first woman to undergo ceramic hip resurfacing at the trust. The operation was performed by Mr Shakir Hussain, consultant orthopaedic surgeon at the trust and at this practice.
The significance is larger than one operation. Women were effectively unable to choose hip resurfacing from around 2012, because the metal implants of that era performed poorly at the smaller bearing sizes most women need. The ceramic implant Fria received was developed at Imperial College London and received its CE mark in 2025, designed precisely to reopen the operation to women and to men with smaller femoral heads. The full background is set out in our article on ceramic hip resurfacing in Birmingham and on the hip resurfacing for women page.
Fria's arthritis announced itself the way it often does: through an injury. A twisted leg on a walk left her unable to walk for two weeks, and an urgent referral and X-ray revealed severe osteoarthritis of the hip. At 49, her normal was 15,000 steps a day, yoga, and praying five times a day, which requires kneeling and deep bending. A conventional total hip replacement could have limited the deep flexion she needed; resurfacing offered greater mobility, but as a newer procedure for women it came with less long-term evidence.
What happened next is the part worth reading closely, because it shows how the decision should be made. She was not sold the operation. She was given the options, the literature and the time.
"Mr Hussain provided lots of links and literature and he asked me to go away to do my research. I had a few appointments where we discussed loads of questions."
Fria, speaking to the ROHShe was also told the truth about the evidence: as the first woman to have the procedure at the ROH, there was not yet strong long-term data, though short-term results have been favourable. With that understanding, she chose resurfacing because she wanted, in her words, to get back to normality without restrictions. The trade-offs she weighed are the same ones every candidate faces; the candidacy criteria explain how they are assessed.
This site does not publish recovery fairy tales, and neither did Fria. Four months in, she described the early weeks as genuinely hard: more painful and slower than she had anticipated, with real improvement arriving at around three months rather than the six weeks she had heard quoted for hip replacement. Her muscles, strong and tight from years of activity, made the physiotherapy demanding.
"Compared to where I was before surgery, where I couldn't move, sit or stand without pain, I'm much better. The pain was diabolic before."
Fria, speaking to the ROHShe tracks her physiotherapy progress with an app, is no longer limping as she was before surgery, and is working towards a full return to her job as a Local Authority inspector, to yoga, and to kneeling comfortably in prayer. That is what a real resurfacing recovery looks like at four months: not effortless, but unmistakably moving in one direction. What the operation and rehabilitation involve is set out on the procedure page.
The honest version of recovery is still a better story than the honest version of waiting.
Discuss Your OptionsOne patient story is not a clinical series, and no responsible surgeon would present it as one. Both ceramic implants offered by this practice remain under structured independent surveillance, and every candidate is told exactly where the evidence stands, just as Fria was. But a first is a first: the operation that was closed to women for over a decade is now being performed, at one of Europe's largest specialist orthopaedic hospitals, by Mr Shakir Hussain.
Speaking to the ROH, Mr Hussain put the milestone in these terms: "It is incredibly exciting to be able to offer this technology to female patients who, until now, have been deprived of the benefits of hip resurfacing." His goal, he added, is to enable patients to return to what they love, whether that is sport, work, or daily activities such as prayer, without restriction.
If you were told resurfacing was not an option for you, that answer may now be out of date. The reasons are explained on the for women page, and the implants that changed the answer are detailed on the H1 and ReCerf pages.
Fria's decision started with a consultation, honest information and time to think. Yours can start the same way: an imaging review that establishes whether resurfacing is open to you, with no pressure either way.
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