The questions patients ask most before a first consultation — and before they've had a chance to look at the imaging.
Suitability depends on six things working together: bone quality, head size and anatomy, age, sex (which shapes bearing choice rather than eligibility), activity goals, and general health. Most active adults under sixty-five with hip osteoarthritis and reasonable bone are suitable for at least one of the three implants available today. A consultation with imaging review gives a definitive answer.
The candidacy page walks through each factor in detail.
Not necessarily. Age is one of the six factors, but it is not the deciding one. Patients in their late sixties and seventies are considered where the bone is good and the patient is genuinely active. The answer comes from the imaging and the conversation, not from a birthday.
Often, yes. The clinical picture for hip resurfacing has changed materially with the arrival of the H1 and ReCerf ceramic implants. Patients who were correctly told no in the metal-on-metal era may have a different answer today.
A second opinion is welcomed and does not commit you to surgery.
Yes, and many do. The ceramic implants have reopened the operation for women who were previously advised against it. Ceramic bearings remove the cobalt and chromium ion concerns that drove poorer outcomes in women in the metal-on-metal era. Many women are now resurfaced with the ReCerf or H1 implant.
The dedicated page on hip resurfacing for women covers this in detail.
Weight is a factor in all joint replacement surgery. High BMI increases surgical risk and can affect implant loading. It is one of several things reviewed at consultation. Patients are not refused on BMI alone, but a frank conversation about risk and outcome expectations is part of the assessment.
Bilateral hip arthritis is common in resurfacing candidates. Both hips can be resurfaced. The usual approach is to treat one side first, recover, and address the second side a few months later. In selected patients a single-sitting bilateral resurfacing is possible, and this is discussed individually.
What to expect on the day, in theatre, and in the first hours afterwards.
You are admitted to hospital on the morning of surgery, fasted from midnight. After anaesthetic assessment, surgery takes place under spinal or general anaesthesia. The operation lasts around 90 minutes. You return to the ward from recovery within a few hours, and most patients are walking with physiotherapy support on the same day.
Hip resurfacing typically takes around 90 minutes. Total theatre time, including anaesthetic and preparation, is closer to two to two-and-a-half hours.
Both spinal and general anaesthesia are used for hip resurfacing. The anaesthetist will discuss the options at pre-assessment. Spinal anaesthesia with sedation is often preferred, as it carries a lower risk of post-operative nausea and tends to give better early pain control.
Most patients are discharged one to two nights after surgery. Discharge depends on pain control, mobility with the physiotherapist, and the absence of complications rather than a fixed calendar rule.
Yes. Precise implant positioning is critical in resurfacing, and the learning curve is steeper than for a standard hip replacement. Volume and specialisation matter: surgeons who concentrate their practice on resurfacing consistently achieve better outcomes than those who perform it occasionally alongside a general arthroplasty list.
The timeline questions — and what the data actually say about returning to an active life.
Most patients are walking independently within a week, off crutches in four to six weeks, and back to comfortable daily activities by three months. Full recovery — including return to sport — takes six to twelve months depending on the activity. Recovery is generally quicker than after a stemmed hip replacement because the femoral anatomy is preserved.
Most patients are able to drive at six to eight weeks, once they can perform an emergency stop comfortably and are off all prescription pain medication. The operated side and the type of car (manual or automatic) affect the timeline. You should not drive until you are confident your reaction times are fully normal.
Desk-based work is typically possible from four to six weeks, often earlier with remote working. Jobs that involve significant standing, walking, or physical effort take longer — usually three to four months. The right answer depends on your specific role and is discussed at consultation.
For most well-selected patients, yes. Running is realistic from around six months, with a graduated build under physiotherapy guidance. The larger bearing diameter and the preserved native anatomy support a return to impact that a standard hip replacement does not encourage in the same way.
Low-impact activities — cycling, swimming, golf, walking — are typically possible from eight to twelve weeks. Higher-impact sports including running, skiing, tennis, and racquet sports are realistic from six months with appropriate rehabilitation. Contact sports are assessed individually.
The implant does not formally restrict activity; the guidance is about giving the bone time to integrate fully before loading it hard.
Short-haul flights (under two hours) are generally safe from about six weeks. Long-haul flights carry an elevated DVT risk and are best deferred to three months. Compression stockings and regular movement during the flight are recommended regardless of timing. The specific advice depends on your clotting history and general health.
The questions that come up once patients start reading about implant options and what a bearing choice actually means for daily life.
The Adept is a metal-on-metal implant with the longest registry data in hip resurfacing, suited to active men with larger native heads and excellent bone. The ReCerf is a ceramic-on-ceramic implant that has become the modern default for most candidates, men and women alike. The H1 is a ceramic-on-ceramic implant developed at Imperial College London, a newer ceramic option in the field.
The choice depends on head size, sex, bone quality, and individual preference. Choosing the right one is the substance of the consultation.
In the right patient, yes. The Adept metal-on-metal implant has an excellent long-term record in well-selected patients — active men with large native heads and good bone quality. The problems that affected metal-on-metal resurfacing historically were largely driven by smaller head sizes and poor patient selection.
Regular surveillance (cobalt and chromium blood tests and, where indicated, MARS MRI) detects problems early. Metal-on-metal is not appropriate for women, patients with kidney impairment, or those with known metal sensitivity.
Ceramic implants produce no metal ions and carry no cobalt or chromium exposure risk. They are appropriate for a wider range of patients, including women and those with any history of metal sensitivity or kidney impairment. The ReCerf and H1 ceramics are now the bearings under most active discussion in the literature.
For the right patient, however, the Adept metal-on-metal implant has outstanding long-term data and remains an excellent choice. "Better" depends on who the patient is.
In well-selected patients with a well-positioned implant, registry data show the majority of metal-on-metal resurfacings functioning beyond twenty years. Long-term data for the ceramic implants are still accumulating, but early and medium-term results are favourable. Survival is influenced by implant choice, surgical technique, patient selection, and activity level.
Yes. All three modern resurfacing implants are MRI-compatible. Ceramic bearings produce no significant artefact on MRI, so imaging of adjacent structures is straightforward. Metal-on-metal implants do produce some artefact; specific MARS sequences are used where detailed local imaging is needed.
The questions patients often hesitate to ask. They matter, and they deserve straight answers.
The risks are broadly similar to those of any hip replacement: bleeding, infection, nerve injury, leg-length discrepancy, dislocation, and deep vein thrombosis. Hip resurfacing carries an additional risk of femoral neck fracture, which is rare in well-selected patients but slightly higher than the equivalent risk in stemmed replacement. Adverse reaction to metal debris (ARMD) is a risk specific to metal-on-metal bearings and does not apply to ceramic implants.
Metallosis is the accumulation of metal particles and ions in the soft tissues around a metal-on-metal implant, leading to local tissue damage. It is a known complication of metal-on-metal bearings, most often associated with suboptimal implant positioning or an implant under abnormal load.
Regular surveillance with cobalt and chromium blood tests and, where indicated, MARS MRI is used to detect problems early. Ceramic implants do not carry this risk. There is a dedicated page on metallosis if you want to read more.
Femoral neck fracture is the most resurfacing-specific complication, occurring when the bone of the femoral neck breaks at or near the implant interface. In well-selected patients it is uncommon — registry rates are typically below 1%. Patient selection (good bone quality, appropriate anatomy) and precise implant positioning are the main protective factors.
Resurfacing leaves the upper femur intact. If revision ever becomes necessary, the operation converts to a standard hip replacement with the stem set into a femur that has never been opened. That conversion is technically straightforward and typically gives a good result.
Keeping that option in reserve is one of the structural advantages of resurfacing over primary stemmed replacement — the fallback position is better than if the femur had been used for the first operation.
Practical questions about paying privately, using health insurance, and what is covered.
The fees page gives current self-pay prices. The cost covers the surgical fee, the implant, the anaesthetist, and the hospital stay. Please see the fees page or call Wendy Richards on 07399 114575 for an up-to-date figure.
Most major UK health insurers — Bupa, AXA, Vitality, Aviva, WPA and others — cover hip resurfacing where it is clinically indicated. You will need a valid GP referral and, in most cases, pre-authorisation from your insurer before the consultation or at the point of booking surgery. The practice can advise on the pre-authorisation process.
The all-inclusive self-pay fee covers the surgeon's fee, implant costs, anaesthetist fee, hospital admission (standard stay of one to two nights), routine in-patient physiotherapy, and follow-up appointments within the standard care pathway. Any additional in-patient nights, further investigations, or complications requiring readmission are typically covered separately and are discussed before surgery.
Mr Hussain works primarily in the private sector for hip resurfacing. NHS pathways for hip resurfacing are limited, and access depends on your NHS trust and clinical circumstances. If you are an NHS patient enquiring about options, a private consultation to assess suitability and discuss the pathway is available — it does not commit you to private surgery.
The most useful next step is a private consultation. You will be told plainly whether hip resurfacing is the right operation for you, which bearing would suit, and what realistic recovery looks like for your specific situation.
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