Birmingham Hip Resurfacing
This page provides general information about birmingham hip resurfacing — what it involves, who it may help, how it is performed, and what to consider when planning treatment abroad. This information is for educational purposes only. Final medical advice must come from a qualified healthcare professional who has evaluated your individual case.
Overview
Birmingham Hip Resurfacing (BHR) is a well-known type of hip resurfacing — a bone-conserving alternative to total hip replacement. Instead of removing the ball of the hip (femoral head), the surgeon reshapes it and caps it with a smooth metal covering, while lining the socket with a matching metal cup. This preserves more of the patient’s own bone.
Resurfacing was developed to suit younger, active patients with strong bone, aiming to relieve arthritis pain while keeping options open for future surgery, since less bone is removed. Because it uses a metal-on-metal bearing, careful patient selection and follow-up are important.
This page is an educational overview only. It is not medical advice, and no surgical outcome can be guaranteed. Whether hip resurfacing is right for you can only be decided after evaluation by a qualified orthopaedic surgeon experienced in the technique.
Who May Need This
Hip resurfacing is usually considered for younger, active adults with hip arthritis and good-quality bone, most often men, who want to preserve bone and potentially return to higher-impact activity. Candidates typically have a well-formed, strong femoral head and no significant osteoporosis or deformity.
It is generally avoided in people with weak or osteoporotic bone, certain hip deformities, reduced kidney function, known metal sensitivity, and in women of childbearing potential because of metal-ion concerns. Only a surgeon can determine eligibility after careful assessment.
When It May Be Recommended
Resurfacing may be recommended when hip arthritis causes pain and disability despite non-surgical care, in a patient whose age, activity, and bone quality make bone preservation attractive. It competes with total hip replacement, and the choice depends on the individual profile.
The decision weighs the potential benefits of bone preservation and stability against the specific risks of a metal-on-metal implant. The final recommendation depends on individual evaluation.
Diagnosis and Evaluation
Evaluation includes a history and examination and X-rays to assess the arthritis, bone shape, and quality; sometimes CT is used for planning. Bone strength is important, so factors that weaken bone are checked carefully. Baseline kidney function and, in some centres, baseline metal-ion levels may be measured.
Your general health and a medication review complete the assessment. Because patient selection is key to good resurfacing outcomes, a second opinion can be valuable before deciding.
Treatment Options
Options range from least to most invasive: non-surgical care (weight management, physiotherapy, walking aids, medication, injections); hip resurfacing for suitable younger, active patients; and total hip replacement, which is more widely applicable and does not use a metal-on-metal bearing.
The right choice depends on your age, activity, bone quality, and preferences, and on the surgeon’s experience with resurfacing. Your surgeon will explain the trade-offs.
How It Is Performed
Hip resurfacing is performed under general or regional anaesthesia. Through an incision, the surgeon exposes the joint, reshapes the femoral head and caps it with a metal component fixed with cement, and prepares the socket to receive a metal cup that is press-fit into the pelvis. Precise positioning of both components is critical to reduce wear and metal-ion release.
Stability, leg length, and motion are checked before closing. The procedure commonly takes one to two hours. Because it preserves the large natural head size, dislocation risk tends to be low.
Preparation
Preparation typically includes pre-operative tests, checking bone and kidney health, treating any infections, and reviewing medications — especially blood thinners — with your doctor. Stopping smoking aids healing.
Arrange home help and walking aids for recovery. If travelling abroad, allow for the recommended in-country stay for surgery and early rehabilitation, and bring your imaging and records.
Benefits and Expected Goals
The goals are pain relief and restored mobility while preserving bone. The large head size gives good stability with a low dislocation risk, and suitable patients may return to higher-impact activity than is usually advised after total replacement.
Benefits vary by individual and depend on bone quality and precise implant placement. Resurfacing does not suit everyone, and the metal bearing requires ongoing surveillance. Realistic expectations give the best satisfaction.
Risks and Possible Complications
Resurfacing carries the general risks of hip surgery plus specific concerns related to the metal-on-metal bearing.
- Fracture of the femoral neck under the cap, especially with weak bone
- Raised metal-ion levels or local soft-tissue reactions (pseudotumour)
- Infection, blood clots, or nerve or blood-vessel injury
- Loosening or failure of components over time, needing revision
- Groin pain or fluid collections related to the bearing
- Difference in leg length or persistent pain
Your surgeon will explain the risks specific to your bone and health. Report new groin pain with swelling, fever, spreading redness, or a sudden change in leg position with severe pain promptly.
Recovery, Follow-up & Aftercare
Recovery varies by patient. Early physiotherapy and walking with aids begin soon after surgery, progressing over weeks. Because the bearing is metal-on-metal, long-term surveillance with periodic blood metal-ion tests and imaging is recommended to detect any problems early.
Blood-clot prevention, wound care, and rehabilitation are important. Attend follow-up appointments and X-rays, and arrange this ongoing surveillance with your local doctor before travelling home.
Medical Tourism Planning
If you are considering hip resurfacing abroad, choose a JCI- or ISO-accredited hospital with a surgeon who performs resurfacing regularly, since implant positioning and patient selection strongly affect results. Confirm the plan for metal-ion surveillance and how complications and follow-up would be handled.
Plan for the in-country stay your team recommends, confirm your fitness to fly afterwards, and arrange ongoing physiotherapy and surveillance at home. Consider medical travel insurance, and request a written treatment plan and cost estimate before you travel.
Estimated Cost Factors
The cost depends on the country and hospital, surgeon’s fees, the implant system, anaesthesia, length of stay, physiotherapy, and ongoing surveillance testing. Complexity and any complications affect the total.
Many international destinations offer hip surgery at a fraction of typical US prices, but figures vary widely by case. Online prices are only estimates — always request a personalized written quote for your specific situation before deciding.
Choosing a Hospital or Specialist
Look for recognised accreditation (JCI, ISO, or a strong national equivalent) and a surgeon with specific, regular experience in hip resurfacing and good outcomes, since it is more technique-sensitive than standard replacement. Confirm board certification and ask about implant positioning and surveillance protocols.
Ask about international patient services, interpreter support, physiotherapy facilities, and the follow-up plan. Transparent written cost and treatment plans and clear communication are signs of a quality programme.
Alternatives
The main alternative is total hip replacement, which is more widely applicable, avoids a metal-on-metal bearing, and suits patients with weaker bone. Non-surgical care (weight management, physiotherapy, medication, injections) can manage symptoms in earlier disease, and joint-preserving procedures may help selected younger patients.
Each option has different benefits, risks, and recovery. Discuss all of them with your surgeon so the plan fits your hip, bone quality, and activity goals.
Questions to Ask Your Doctor
- Am I a suitable candidate for resurfacing rather than total hip replacement, and why?
- How is my bone quality, and does it affect the risk of fracture under the cap?
- How often do you perform hip resurfacing, and what are your outcomes?
- What metal-ion surveillance will I need, and how often?
- What are the specific risks in my case?
- How long should I stay in-country, and when can I fly home?
- What is included in the written cost estimate?
✅Safety Checklist Before Traveling
Use this checklist to help ensure your safety when planning medical treatment abroad.
- Verify hospital accreditation (JCI, ISO, TEMOS)
- Verify specialist credentials and board certification
- Get a written treatment plan from your doctor
- Get a written cost estimate with included/excluded items
- Arrange follow-up care with your local doctor
- Confirm medical visa and travel documents
- Consider medical travel insurance
- Keep copies of all medical records and reports
- Share your travel plans with a family member or companion
- Know the emergency contact numbers at your destination
🚨 When to Seek Urgent Medical Help
Contact a healthcare provider immediately if you experience any of the following:
- • Severe chest pain or difficulty breathing
- • Heavy or uncontrolled bleeding
- • Sudden weakness, confusion, or loss of consciousness
- • Severe allergic reaction (swelling, rash, difficulty breathing)
- • High fever (above 101°F / 38.3°C) after a procedure
- • Worsening pain, redness, or swelling at a surgical site
- • Any symptom that feels severe, unexpected, or concerning to you
After hip resurfacing, seek urgent care for fever with increasing pain, redness, or wound drainage, a leg that suddenly appears shorter or rotated with severe pain, calf pain or swelling, sudden shortness of breath or chest pain, or new groin pain with swelling.
🚨 If you have a life-threatening emergency, call local emergency services immediately. Do not wait.
Frequently Asked Questions
In resurfacing, the femoral head is reshaped and capped with a metal cover rather than removed, so more of the natural bone is preserved; the socket is lined with a metal cup. In total replacement the head is removed and replaced with a ball on a stem. Resurfacing is bone-conserving and used in selected patients, while total replacement is more widely applicable.
It is generally best suited to younger, active patients with strong, good-quality bone — most often men — who have hip arthritis but a well-preserved femoral head. It is usually avoided in people with weak or osteoporotic bone, certain deformities, kidney problems, metal sensitivity, and in women of childbearing potential because of metal-ion concerns.
Resurfacing uses a metal ball against a metal socket, which releases small amounts of metal ions (cobalt and chromium). In most well-positioned implants in suitable patients this is not a problem, but raised ion levels or local reactions can occur, so surveillance with blood tests and imaging is recommended. Discuss these risks with your surgeon.
Because it preserves bone and the natural femoral head size, resurfacing may allow a return to higher-impact activity for suitable patients, and the risk of dislocation tends to be low. Even so, your surgeon will advise limits based on your bone quality and implant, and no outcome is guaranteed.
Yes. Choose a JCI- or ISO-accredited hospital with a surgeon experienced specifically in hip resurfacing, since implant positioning is critical. Confirm the need for metal-ion surveillance, plan enough in-country time for early rehabilitation, and arrange follow-up at home. Always request a personalized written quote.
References
This section lists sources supporting the information on this page. Content is periodically reviewed for accuracy.
- • American Academy of Orthopaedic Surgeons (AAOS) — Hip Resurfacing
- • National Institute for Health and Care Excellence (NICE) — Metal-on-Metal Hip Resurfacing
- • Cleveland Clinic — Hip Resurfacing