Debate: Hip Resurfacing vs. Anterior Total Hip Arthroplasty

[@dapperdoggy]

I had Birmingham resurfacing 15 years ago and it has been fabulous. My hip feels great.I'am a female 70 years old

[@eickysharma2469]

I had also AVN on both hip .Confuse in what to do hip replacement or hip resurfacing. Will you please suggest me nicely ?Will you please give me email address sir .

[@theeditorrestrial]

I had resurfacing on both hips...in my 40s. Yeah...had acetabular impingement for years and had no idea. I was a tennis instructor and participated in martial arts training which was halted quickly. I went a good 6 years dealing with the pain and then it got pretty gnarly so decided to have resurfacing back in 2009 and so far so good!

[@thoritsu]

Same here!

[@benrodnisky1]

Did you do both sides at the same time ? When you say so fas all is good you mean you are back to playing tennis and do martial arts ? Thx for answering

[@thoritsu]

@@benrodnisky1 I did them two weeks apart. Doing them the same day would be completely debilitating, and I was advised against doing them the same day. After the two weeks apart experience, I totally agree. In two weeks, I could pretty much walk without any crutches, cane or assistance. Then you do the second. Then, two weeks more, and you can get around unassisted again. That worked great. Back to soccer in 18 months. I also practice martial arts, but wasn't in a school then. 12-18 months would be fine. Tennis would have probably been a little faster. After a year, it is mostly up to you.

[@theeditorrestrial]

@@benrodnisky1 had the left done in June and the right done in July so pretty much back to back and yes I’ve been back out on the court and biking since healing 100% which took me around 4 weeks. This was in 2010 or so. Someone mentioned a new process to which they use poly compound on metal which avoids metal rub and potential metal ions in blood so I’d look into that now. So far my metal count is low low.

[@benrodnisky1]

@@theeditorrestrial amazing ! Be well

[@danmcarthur8077]

I had a total hip replacement posterior and I can't tell the difference now. Running all the time lifting heavy its been awesome

[@sea578]

My husband had resurfacing 4 years ago. No one would touch him due to osteomyelitis in same leg. One doctor offered resurfacing and gave him his life back.

[@tomm8025]

Hate to say it, but this lady got her butt whooped in this debate...her arguments are not well researched, some of her numbers are false and she is using old devices that are no longer used for her argument NOT BHR which he specifically detailed.....her biggest excuse is "we don't know"....but decades are behind it now....we do know resurfacing is far better for the right patient....younger active males and bigger boned male are best. I am looking forward to getting my Resurfacing this year so I can return to my life.....THR would have too many limitations.

[@jamescolvin5995]

I had a resurfaced hip 21 years ago. I also enjoyed playing racketball again after I had healed. I also resumed aggressive bicycling. I am now 72 and doing well. My Doctor was Doctor Gross of Columbia South Carolina.

[@user-zb7tg5hi3t]

Does the hip resurfacing cause premature wear to the acetabular?

[@BrettLambkin]

I’m a 52 year old cyclist, netball umpire, and ex-baseballer. I’ve just had my second Birmingham and am recovering. So happy with the first one from 2 years ago. I don’t think that the female speaker spoke well. Maybe I’m biased. 🤷🏽

[@autoazure]

I am a long distance runner from Scotland who had bone on bone OA. Had a resurfacing performed by Prof Dominic Meek (Glasgow). Subsequent to recovery, I run 55 miles per week and have returned to competitive running at the age of 65! Now 2 years in! Also, what about Andy Murray the Tennis player?

[@mattspringer9298]

Glad to hear your resurfacing has allowed you to continue running. I’m also an ultra trail runner looking into hip replacement vs resurface. My Dr didn’t even mention resurface as an option. It sounds like a better deal for me More research to do.

[@LOU153M]

Hi Jim, I also live in Glasgow (29) and may need this procedure and have never came across anyone that's had the surgery in Glasgow. Thanks for sharing! I don't run more than ~1-2 km but I love hillwalking, swimming and traveling lots. Unfortunately had to quit martial arts due to hip problem. Was your experience getting this procedure, experience with surgeon and the hospital stay positive?

[@autoazure]

@@LOU153M Very positive, done on the NHS however, Mr Meek also does private resurfacing.

[@tomm8025]

The Undertaker WWE wrestler, a pro Hockey player and a MLB Pitcher....among many pro athletes who have gone back to compete at the highest levels.

[@cristianoronaldo-jw4mj]

@@tomm8025 Undertaker ? No way ?

[@BigD12396]

I am 10 years in to a BHR and its been amazing so far. Been very active...No real impact sports like running or kick boxing but ive done lots of walking (Including Hills and Mountains), cycling, punching heavy bags and weights with no problems..... I also have a younger girlfriend who is not complaining ;-) I do find I need another one now (Hip, not girlfriend)....which is why I have found myself researching again. I am waiting for my blood test to come back then I will decide. Apparently, people with BHR need blood testing every year...in that respect I have been failed. What ever you decide to do I wish you all the luck and success possible.

[@justabill5780]

I'm a runner and martial artist(Taekwon-Do and Kickboxing). I had THA (anterior approach) at 46 years old. Within 6 months of the procedure, I was back to running and martial arts. I also lift weights and I can do weighted bridges with 600lbs. NEVER had a problem with my new hip and it has been 5 years.

[@alistairbratten4083]

I am a 61 year old male triathlete, i had a left hip resurfacing exactly 2 years ago, all went well text book operation and recovery. Got back to swimming immediately and cycling gradually over the next 6 to 9 months and i am going really well at both. The problem i have is with running after about 15min very slow running my hip seems to tighten up and the pain is so intense i have to stop and walk/limp after a few minutes walking i can run a short distance again. I have been to physio done all the exercises but still no better, has anyone ever had this problem and how do i get past it. Please help. Alistair

[@jscotlandr]

Dr F ignores the study showing patients that have both a THR and a resurfaced hip. The resurfaced hip is vastly higher rated. Also, she is using old data on the resurfaced hip issues.

[@garync3810]

Very interesting to hear both sides. It would have been helpful to see their slides. Thanks!

[@jscotlandr]

Dr F did have a very good point about the bone sparing aspect in the Resurfaced hip not holding true for the acetabular portion.

[@eemerson7800]

There is no debate! Resurface is fan frickn tastic!

[@bokatorus771]

Hip Resurfacing requires special skills. Only a few doctors in the whole world have successful records. You need special training. Stop blaming on metal on metal. I have hip resurfacing. It is very successful - run, jump, bike, kick, squats, hike, lifts - the whole nine yards. I can do everything. The data is out there, published by the few successful doctors. Top professional athletes (Andy Murray, Ryan Kelser, Patrick Kane, Colby Lewis, Michael Rix, on and on ) only get hip resurfacings to continue their career. The total hip replacement requires less skill (or thinking) to do surgery. You let the prothesis do the work. Hip resurfacing requires placement (needs thinking).

[@anteriorhipfoundation]

Placement is everything in a hip replacement.

[@bokatorus771]

@@anteriorhipfoundation Hip resurfacing requires double or triple the skills and efforts - Cup placement, shaving off the balls, put the ball and stem in the femor head, making sure you do it at the right angle(3 axis placement), need to build the femor head for cap. Hip replacement - cup placement and cut the femor head off, the ball is prefabricated at 'factory' (less skill and less effort by the surgeons). The spikes goes down mostly one way into the thigh bone.

[@connieclark6167]

I had a hip resurfacing done just before my 70 th birthday, I’m female with long thin bones, it was a slow healing and plenty of PT. The doc left my other leg about 7mm shorter, which is now requiring a lift in my shoe. For about 2 months I felt like I was going to fall off my perch. He was rated a top 10 doctor but I think maybe he was training others also. Ever since my surgery my good ankle on the other leg has had nerve problems, and now I think this pain around the bottom of my heel is tarsal’s tunnel? Don’t think I’ll do it when my other side goes total bone on bone. I’m at 2.5 years out…

[@tomm8025]

I am surprised they did resurfacing on you as you were older, thin boned and female...not a great candidate for resurfacing. As a 54 year old (as of a couple weeks ago) and larger framed male, I am looking forward to resurfacing....just hard to find a surgeon in my area that does them and has significant experience. So I will likely go out of state to have my done. 3 years of pain -- while significantly less then when the issue first started -- and I am ready to just be pain free...even though I can tolerate the pain I have now it is a deterrent to a lot of things I would normally be doing.

[@jscotlandr]

I agree with @tomm

[@MenaGadalla-ly3oe]

Which surgeon did your surgery? @connie Clark

[@connieclark6167]

@@MenaGadalla-ly3oe , Dr. James Pritchett in Seattle wa

[@coresurf22]

Dr Pritchett knows!!

[@sjwolf]

Left hip Cormet 2000 resurfacing ... installed 2002 still looking perfect. Male 70. Having a BHR installed on the right shortly.

[@dr.prashantsharma4728]

Really Loved this session Filled with Serious discussion and hilarious Humour 👍😅

[@TheRealEricRose]

Well I fully disagree with everything she has said…

[@coresurf22]

both make very good points; agreed, different demeanors, that’s for sure, but she also makes some good points regarding early failure and revision rates, and subsequent revision surgery challenges.

[@kerryobrien71]

Dr Ferguson came across as pretty arrogant, and then just gives her personal opinion/experience without support of any rigorous empirical evidence. Just talk about the objective research evidence (not personal experience), if that evidence is not available, then moderate your arguments accordingly.

[@PacLevkov]

I am 33 yrs old with AVN diagnosed on my right hip head 3 years ago. Can the resurfacing be applied to patients with AVN? I’ve just start to research because I want to do the surgery cuz of my pain increase. And can the resurfacing be combined with X-linked polyethylene implant?

[@johnjohnson9918]

I was born with club feet and the orthopedic surgeons in the 70s were always looking at my overall walking and health. Now when I go it’s like a car dealership, I need insurance referral for every joint, they only check one when all mine are of course have birth defects. They want to sell me joints, surgery’s and injections. I’ve survived 55 years no surgery with double club feet and bilateral hip impingements. I can say without a doubt they are looking at us like we are just money, these medical devices have ruined the profession. You really have to seek out a good doctor that has your needs in mind not looking to sell you the most expensive device to make themselves rich.

[@maryhobbs2692]

Just because those that have hip resurfacing have anecdotal good outcomes does not mean statistically speaking, the results are better. Please let scientists and statisticians do their job.

[@tomm8025]

It is for the RIGHT candidate as the first surgeon said....which is what many of the leading resurfacing surgeons say. Fact is surgeons who do resurfacing also do THR as well. Therefore, I would NEVER let a surgeon who ONLY does THR tell me a replacement is better, I would only let a resurfacing surgeon tell me a replacement is better (if that be the case) and why, else I am getting resurfacing. Oh, and as of 2022, the evidence is a lot more then anecdotal.

[@toddkern7397]

I had a BHR 19 years ago by dr De Smitt so far so good

[@mr.brenman2132]

@Mary Hobbs Hip resurfacing has better outcomes and it's an objective fact that THR limits function.

[@mr.brenman2132]

​@@tomm8025 Resurfacing procedures take longer and require more expertise. That's why surgeons like her don't won't to perform them. More schooling is required.

[@tomm8025]

@Mr. Brenman21 I have pointed out the exact same thing on multiple threads. It takes additional time and money to get additional training and certifications to do resurfacing, the pool of patients will with hip issues that are good candidates for resurfacing is smaller and the actual surgery takes longer for basically the same pay. As a "business decision" many surgeons simply won't learn it. But those who do it and do it well stay very busy. I just flew across the country two months ago to have one of the world leaders in the procedure resurface my hip. Feels fantastic. I had more range of motion and flexibility at two weeks post surgery than someone with THR could ever expect. I KNOW it was the right decision for me. So glad I spent the money to travel and get a BHR over a THR.

[@mendozaconsultation]

IS there weight limitations for people needing either surgery, and is there table weight limits.? As far as antibiotics, i was told that if on them prior to and during recovery,you should take pre biotics because antibiotics, deplete your immune system.?

[@robinshepard4571]

Do I know if a doctor will give me my hip resurfacing and I need a hip resurfacing and he chooses to do the hip replacement because it's going to make more money in the pockets of the corporation

[@earnmyturns6305]

why must resurfacing have the be metal on metal? why can they use ceramics in replacement but not in resurface?

[@connieclark6167]

Mine is ceramic hip resurfacing

[@divyanshsinghrathore4164]

​@@connieclark6167what's the name of your implant? Is it recerf? Hope you are doing good.

[@racebannon2332]

It’s not FDA approved for the US.

[@racebannon2332]

@@connieclark6167unfortunately we do not have that option in the US

[@divyanshsinghrathore4164]

@@racebannon2332 brother there,s a doctor in chennai india who does hard on soft resurfacing. Many foreign patients come to him. Does hard on soft means metal on polyethylene or something else? Please share if you have any idea.

[@racebannon2332]

As a surgeon, the layman listening to this believes resurfacing is the better procedure. Actually it’s the more conservative approach, albeit a more difficult surgery. The major problem is metalosis and this is devastating. In the US, only metal on metal (Birmingham) is available and a significant number of patients have increased levels of chromium. This is understated as it’s a major contributor to cancer, heart disease, dementia, etc. Most total hips are ceramic on cross-linked polyethylene which is well tolerated. If resurfacing had ceramic on ceramic or polyethylene, it would be a game changer. I’m having surgery in the near future and I prefer ceramic, I’m going with a total.

[@aroopchandra]

I these days resurfacing also uses ceramic on polyethylene kzbin.info/www/bejne/jJKVloZ_pMikgcUsi=bSUX7rfCnh4jB58z&t=84

[@8180634]

Thanks for commenting. When I google, I see references to using ceramic for hip resurfacing. Is this perhaps new? I'm debating myself between total hip and resurfacing, hoping to return to motocross (~50yo/male). I'm afraid of breaking my femur on a hard landing or if I have to jump off the bike with total hip replacement, and wondering if resurfacing reduces the odds of a bad femur break, or at lest is easier to recover from if it breaks since there's no metal down the center.

[@sjwolf]

Usually, the problem is improper alignment of components causing excessive wear. Which translates to high ion levels and potentially metalosis. Properly installed the wear almost flatlines after a few months. Ref: Cormet 2000 data.

[@racebannon2332]

@@sjwolf you are correct. The issue is the surgeon and resurfacing is very technique sensitive. Once breakdown begins on the components it’s game over. 50 yrs and under, I would go resurfacing but once you’ve 60, a total hip maybe more ideal.

[@sjwolf]

Reason for restricting age? I would think bone quality would be the deciding factor.

[@celesteredding1550]

Why say survival? Why not say satisfaction?

[@ivasashamariapavic6689]

What about female?

[@madalinsandulescu8757]

The only reason some will still want to use THR (in the age of creamics for hip resurfacing) for young people and were hip resurfacing will be just a better option, it’s just because of the “money buisness”, because we all know that in max 10 years one with THR will need revision. The lady is so nervous, and if someone shout louder is because he/she is hiding something!

[@mattspringer9298]

I agree with you. Didn’t like her approach to the discussion; “I totally reject everything he just said” followed by this is all just my opinion. Etc. I really need to know the fact even if limited or inconclusive Resurface sure sounds like better option IF as first Dr said you are a good candidate. Thanks

[@tomm8025]

Exactly! Fact is surgeons who do Resurfacing have to get additional training and certification and the actual surgical procedure takes longer.....along with the fact that a smaller percentage of patients make good candidates....thus surgeons can forgo the time and expense of learning resurfacing and make up reasons suggesting THR are better.....but their reasons don't hold up for good resurfacing candidates if you do your research.

[@rongracilla6164]

Show Source for your 10 yr revision claim. It’s not being seen in the current data. Thanks

[@mr.brenman2132]

​@@rongracilla6164 THR is garbage. Anyone that qualifies for resurfacing should get the resurfacing. It's an objective fact that THR limits function.

[@coresurf22]

@@mr.brenman2132 can you please share your doctor’s name and contact info? I am in San Diego and Kaiser just barely recently offered anterior THR in the past 6-months and no mention of resurfacing as an option. ughhhh

[@randomlyentertaining8287]

If resurfacing was enough for Mark Calaway to go on and keep performing as he did for the last few years of his career, it's good enough for the average person lol

[@racebannon2332]

Calaway acknowledges he can barely walk in the wake of bilateral resurfacing procedures. One hip will never be ideal and he’s in constant pain. Now he needs to worry about metalosis

[@coresurf22]

@@racebannon2332whoa! that’s not good.

[@rickreichard9979]

She is the worst type of doctor who has not read the information on BHR. She only cites the short term failures which are statistically low. THR is being pushed because more ham-fisted orthos can do it without having to master and certify the femoral tip preparation-pilot holes, measurements, geometry, cemented, uncemented. The acetabular preparation is generally the same for both.

[@gortsearthblog9803]

I totally agree i think you have hit the nail on the head .After 6 years of crippling pain Osteoarthritis i had both my hips resurfaced BHR,at age 54 , after recovery of about 12 months i started doing Shotokan Karate and within 4 years i attained my black belt ,i have taken part in 2 National Karate full contact fighting competitions and won many fights and placed 3rd overall , I competitively spar every week right up to present i am 62 years old . I have never felt better . All Hail BHR.

[@tomm8025]

Exactly what I said in some of the comments on this page....rather than incur the time and expense of additional training and certification, surgeons can just claim THR is better.....but it's better for them. I would NEVER let a surgeon who ONLY does THR tell me a replacement is better, I will only let a resurfacing surgeon tell me a replacement is better (if that be the case) and why, else I am getting resurfacing.

[@mr.sandman2811]

@@tomm8025 cheers im from europe, my father needs one we have money so we could do somewhere were it is very good. Thanks also Tom for all the resurfacing pro comments, there is not one thr pro comment here. Any recommendations of countries and doctors?

[@tomm8025]

@@mr.sandman2811 - Hello Sandman. I just had my Hip Resurfacing surgery 3 weeks ago. I felt very fortunate to have it done by one of the world leaders in the procedure, Dr. Peter Brooks of the Cleveland Clinic at Indian River Hospital in Vero Beach, Florida. You can do an initial consultation by video. I flew across the country (America) to have him do mine and he appears to have a LOT of people fly to him from all over the world. He recently moved from Ohio to Florida, so right now is a good time to book with him as many have not caught up with his new location (although always with Cleveland Clinic). I could not believe the amount of flexibility I had in my hip in only one week and every single day for three weeks I have had noticeable improvement from the day before. I am currently walking about a half a mile each night (I add a little more distance each day) and as of yesterday I am using one crutch instead of two. I almost feel like I could walk without the crutches but will adhere to using one until six weeks is up as Dr. Brooks requires only 75% weight on the operative hip the first six weeks. I flew into Florida the weekend before my Wednesday surgery. On Monday I had a couple pre-operative appointments, Wednesday my surgery....I was released from the hospital in Thursday afternoon and flew back home Saturday night. I am truly surprised at how much pain free movement and flexibility (that you would never have with a THR) I already have.....I feel so good that I am already looking to schedule some travels a month from now. I have had 13 surgical procedures in my life, many orthopedic related, but I think my Hip Resurfacing has already had the most impact in my life in a positive way. My hip pain is gone, the healing from the surgery is rapid and I envision getting back to life the way I want to live it, without restrictions. I highly recommend Dr. Peter Brooks. By numbers, I believe he has done the 3rd most Hip Resurfacing procedures in America and the 5th most in the world. His incident rate is very low and most of those did not follow post-op instructions. I know there are some other very good surgeons in America for the procedure (Dr. Su in New York, Dr. Gross in South Carolina) but I have always received excellent health care at Cleveland Clinic. Sorry not familiar and did not research the surgeons outside of America although I kept seeing the name Dr. Smet.

[@michaelpfuntner8109]

She doesn't know what she is talking about I just had hip resurfacing and it is perfect and I'm 60 years old

[@SnoopSimmonsSound]

Where did you get your procedure done?

[@michaelpfuntner8109]

@@SnoopSimmonsSound I got it done at Midland orthopedic in South Carolina the Dr Thomas gross he is the number 1 hip surgeon in the world

[@sjwolf]

Dr Gross is excellent. He has performed over 7000 resurfacings. He did one of my hips 22 years ago.

[@robinshepard4571]

Well said 😂😂😂😂❤👍ℹ️🇺🇸💫🌎💪🌹

[@jscotlandr]

Bad surgeons - bad results.

[@garync3810]

True, but sometimes bad results happen with good surgeons.

[@user-zb7tg5hi3t]

I heard that the metal on metal hip resurfacing implants are causing issues with patients. Do they make a better ceramic inplant that lasts longer?

[@FreeVoice621]

I had resurfacing done 10 years ago at the Hospital For Special Surgery (NYC) and I have had zero complications/problems, and I'm back to full activities. Last follow up blood test done this past June show no metal ion problems at all. I would recommend this procedure before doing a total hip replacement (the benefits are verry clear).

[@sjwolf]

MOM resurfacing 22 years ago. No issues to date. Just scheduled a resurfacing for my other hip. Alignment is critical.