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Ceramic Hip Resurfacing

Ceramic hip resurfacing replaces the metal-on-metal bearing with ceramic-on-ceramic: no cobalt, no chromium, no blood monitoring. Here is how it works, who it suits, and what it costs in the UK.

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Medically reviewed by Mr Shakir Hussain MBBS MRCS FRCSEd (Tr & Orth), Consultant Orthopaedic Surgeon, Royal Orthopaedic Hospital Birmingham

The operation

What Is Ceramic Hip Resurfacing?

Ceramic hip resurfacing is a bone-preserving hip operation in which the worn surfaces of the joint are replaced with a ceramic-on-ceramic bearing, rather than the metal-on-metal bearing used in traditional resurfacing. The femoral head and neck are kept, so more of your natural bone is preserved than in a total hip replacement, and because both bearing surfaces are ceramic, no cobalt or chromium ions are released and no metal-ion blood monitoring is needed.

In every other respect it is the same operation as hip resurfacing has always been: the femoral head is reshaped and capped, the socket receives a matching cup, and the large bearing that results gives the hip stability that suits an active life. What the ceramic bearing changes is who can safely have it. The metal-ion concerns that narrowed resurfacing to a specific group of patients in the 2010s do not apply to a bearing that contains no cobalt-chromium surfaces.

Post-operative X-ray of ceramic ReCerf hip resurfacing of the right hip, showing the resurfacing cap on the preserved femoral head and the matching cup in the socket, performed by Mr Shakir Hussain, Birmingham
A ceramic hip resurfacing on a post-operative X-ray: the cap sits on the preserved femoral head, the neck is retained, and the matching cup lines the socket.
400+
hip resurfacings performed by Mr Hussain
Zero
cobalt or chromium released by the bearing
3
implant systems offered: Adept, ReCerf, H1
The bearing question

How Is Ceramic Different from Metal-on-Metal?

The difference is the material the two moving surfaces are made of, and everything that follows from it. A metal-on-metal bearing releases small amounts of cobalt and chromium as it wears, which is why patients who choose it accept lifelong blood-ion surveillance. A ceramic-on-ceramic bearing releases neither, so the surveillance question falls away entirely, and with it the reasons the operation was restricted for women and smaller-framed patients.

Ceramic resurfacing Metal-on-metal resurfacing
Bearing surfaces Ceramic cap on ceramic cup Cobalt-chromium cap on cobalt-chromium cup
Metal ion release None from the bearing Measurable cobalt and chromium ions
Blood monitoring Not required Lifelong periodic blood-ion checks
Who it suits Women, smaller hips, metal sensitivity, kidney impairment Active men with larger native femoral heads
Track record Newer bearing; follow-up accumulating Decades of registry follow-up
Implants offered ReCerf and H1 Adept
Self-pay package £13,450 at ROH private care £12,250 at ROH private care

The honest trade Ceramic removes the metal-ion question; metal-on-metal offers the longer documented track record. Neither is universally better, and the full story of the older bearing, told plainly, is on the metal-on-metal page.

Patient selection

Who Is Ceramic Hip Resurfacing For?

Ceramic resurfacing suits people who want the bone preservation, stability and activity levels of a resurfacing, but for whom a metal bearing is either unsuitable or unwanted. In practice that describes most of the patients the metal era excluded, and a growing share of those it did not.

A strong fit when

  • Women, including those of child-bearing potential
  • Smaller-framed patients with smaller native femoral heads
  • Known metal allergy or sensitivity
  • Reduced kidney function, where ion clearance is a concern
  • A preference to avoid lifelong blood-ion surveillance
  • Active patients who want bone preserved for the decades ahead

Other options considered when

  • Bone quality is not strong enough to support a resurfacing
  • The shape or condition of the femoral head is unsuitable
  • A total hip replacement better fits your age and goals
  • The longest documented track record matters most to you, where the metal-on-metal Adept may be discussed

Suitability Whether a resurfacing of any kind is right for you rests on your bone quality, anatomy and goals, assessed on imaging and examination. Start with am I a candidate? and, for the specific considerations women bring to this decision, hip resurfacing for women.

The device

Which Implant Is Used?

The ceramic resurfacing implant used most often in this practice is the ReCerf, a ceramic-on-ceramic hip resurfacing made by MatOrtho. A second ceramic option, the H1, is also offered where it fits the patient better. Which device suits your hip is a clinical decision made on your anatomy and imaging, not a catalogue choice.

ReCerf ceramic-on-ceramic hip resurfacing implant sample: the textured, bone-facing outer surface of the acetabular cup resting on the polished BIOLOX delta ceramic femoral cap, as used by Mr Shakir Hussain, Birmingham
Sample ReCerf components: the textured, bone-facing outer surface of the acetabular cup resting on the polished BIOLOX delta ceramic femoral cap.

Mr Shakir Hussain performs hip resurfacing across three implant systems, the metal-on-metal Adept and the ceramic ReCerf and H1, which means the recommendation you receive is driven by your hip rather than by the limits of a single device. The full specification and background of each implant is set out on its own page, and side by side on the implants overview.

Fees

What Does Ceramic Hip Resurfacing Cost?

Ceramic (ReCerf) hip resurfacing costs £13,450 as a fixed-price, all-inclusive self-pay package at Royal Orthopaedic Hospital private care (The Woodlands Suite). That single figure covers Mr Hussain's surgical fee and the anaesthetist's fee, the implant itself, theatre time, your hospital stay, in-patient physiotherapy and routine post-operative follow-up. Packages at Priory Hospital Edgbaston and The Harborne Hospital are quoted individually. The £250 initial consultation is charged separately, and your written, itemised quotation is confirmed after your consultation.

Insured patients do not need the package at all: hip resurfacing is covered by most comprehensive UK private medical policies where it is clinically indicated, and Mr Hussain is recognised by the major insurers. The full breakdown of self-pay and insured routes is on the fees and insurance page.

A written quotation takes one consultation. Bring your X-rays if you have them; if not, imaging is arranged on the day.

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Access

Where Is Ceramic Hip Resurfacing Available in the UK?

Ceramic hip resurfacing is a young procedure performed by a small number of UK surgeons, concentrated in specialist hip units. Mr Shakir Hussain performs it in Birmingham, consulting at the Woodlands Suite of the Royal Orthopaedic Hospital, Priory Hospital Edgbaston and The Harborne Hospital, and patients travel from across the UK for the operation.

His resurfacing practice continues a specific Birmingham tradition: he was trained in hip resurfacing by Mr Ronan Treacy, co-designer of the Birmingham Hip Resurfacing. Across the metal and ceramic eras he has performed more than 400 hip resurfacings, and the Royal Orthopaedic Hospital was the setting for milestones in the ceramic era, including the first woman to receive a ceramic hip resurfacing at the ROH.

At 57 and still very active, hip resurfacing seemed the best option for me. From the moment I first mobilised after surgery, the hip felt stable, natural and secure. I was able to walk 1 mile after 2 weeks, progressing to 5 miles pain-free after 5 weeks. I have also returned to cycling and swimming.
Verified hip resurfacing patient, May 2026 · Read verified reviews on Doctify
Common questions

Questions Patients Ask About Ceramic Resurfacing

Is ceramic hip resurfacing available on the NHS?

NHS availability of hip resurfacing varies by region and by trust, and the ceramic implants are a recent addition to the operation. In practice, ceramic hip resurfacing in the UK is currently offered mainly through private care. Mr Shakir Hussain performs it in Birmingham as a fixed-price self-pay package, and most comprehensive private medical insurance policies cover hip resurfacing where it is clinically indicated.

Do I need blood tests after ceramic hip resurfacing?

No routine metal-ion blood monitoring is needed after ceramic hip resurfacing, because a ceramic-on-ceramic bearing does not release cobalt or chromium ions. This is one of the main differences from metal-on-metal resurfacing, which involves lifelong periodic blood checks. You will still have routine post-operative follow-up with X-rays, as after any hip operation.

Can women have ceramic hip resurfacing?

Yes. The ceramic bearing is the development that reopened hip resurfacing to women. Metal-on-metal resurfacing is not recommended for women of child-bearing potential and performed less well in smaller hips, so for many years most women were steered towards total hip replacement. Ceramic resurfacing removes the metal-ion question and is manufactured in sizes that fit smaller anatomy, so suitability now rests on bone quality and anatomy rather than sex. The full picture is on the for women page.

How long does ceramic hip resurfacing last?

Ceramic resurfacing implants are newer than metal-on-metal, so they do not yet have the decades of registry follow-up that older bearings have accumulated. Modern medical-grade ceramic is a hard-wearing bearing material with a long history in total hip replacement, where it has been used for decades and wears extremely slowly. Every ceramic resurfacing performed in this practice is followed up over the long term, and the honest state of the evidence is discussed openly at consultation.

How much does ceramic hip resurfacing cost in the UK?

With Mr Shakir Hussain in Birmingham, ceramic (ReCerf) hip resurfacing costs £13,450 as a fixed-price, all-inclusive self-pay package at Royal Orthopaedic Hospital private care: the surgeon's and anaesthetist's fees, the implant, theatre time, hospital stay, in-patient physiotherapy and routine post-operative follow-up. Packages at Priory Hospital Edgbaston and The Harborne Hospital are quoted individually. The £250 initial consultation is charged separately, and insured patients can use most major UK private medical insurers.

Further reading

Where to Go Next

Next Step

Find Out If Ceramic Resurfacing Fits Your Hip

Suitability is decided on your imaging and examination, not a web page. Mr Hussain will review your hip and tell you plainly whether ceramic resurfacing is right for you, and if not, what is.

Book a Consultation