What it is
Hip resurfacing caps the femoral head with a metal shell and replaces the socket. It preserves more bone on the femur than a standard total hip replacement.
Selected younger, active adults may be candidates when bone quality and anatomy are suitable.
What happens when it occurs
Damaged surfaces are replaced while preserving femoral bone. Rehabilitation focuses on restoring strength, range, and gait while tissues heal.
Common causes and risk factors
- Advanced arthritis or avascular necrosis in younger adults
- High activity expectations and good bone quality
- Consideration of metal-on-metal implant risks and follow-up
Who is most affected
Younger, active adults assessed by surgeons experienced in resurfacing.
Typical symptoms pre-op
- Similar to hip replacement candidates: pain, stiffness, limited walking and sport.
When to seek care
Surgical review when non-surgical care no longer meets goals.
How we diagnose
History, examination, and imaging including X-rays. Blood and imaging follow-up may be advised for metal-on-metal bearings.
Management
- Prehab for strength and home set-up
- Early mobilisation with aids, then strength and balance rehabilitation
- Long-term activity planning based on goals and surgeon guidance
Rehabilitation milestones
Phase 1 days 0 to 7: transfers, gait with aids, gentle strength.
Phase 2 weeks 1 to 6: progressive strengthening and gait.
Phase 3 weeks 6 to 12: balance, endurance, community walking.
Phase 4 months 3 to 6: graded return to sport as cleared.
Readiness to progress
- Pain under control and wound healed
- Stable gait and good balance
- Strength targets met across key movements
Prevention / long-term care
- Regular follow-up as advised for metal-on-metal bearings
- Maintain strength and healthy weight
- Avoid high-impact overloads unless cleared
Australia snapshot
- Performed in selected centres by experienced surgeons
- Used for a subset of active adults
- Follow-up protocols for metal bearings are established
Latest insights
Candidate selection matters most. Rehabilitation principles mirror total hip replacement.
Follow-up is important for metal-on-metal implants.


