At Palmetto Bone and Joint, our commitment is simple: we always prioritize what is best for our patients. In the world of orthopaedic surgery, trends come and go—but science, outcomes, and ethics must guide everything we do. That’s why we believe it’s important to speak openly about hip resurfacing, a procedure that continues to be promoted by some surgeons despite overwhelming evidence that it poses unnecessary risks and offers little benefit over modern total hip replacement—particularly when performed through the anterior approach.

In fact, we believe the continued use of hip resurfacing is not only outdated—it raises serious ethical concerns.

What Is Hip Resurfacing?

Hip resurfacing is a type of joint surgery where the femoral head (the “ball” of your hip joint) is shaved down and capped with a metal implant. The socket (acetabulum) is also replaced with a metal cup. It was originally developed as a “bone-preserving” option for younger patients, promising better function and easier future revisions.

But over time, the data has become clear: these promises haven’t held up—and the risks far outweigh the theoretical benefits.

The Serious Risks of Hip Resurfacing

Despite marketing efforts that make resurfacing sound modern or minimally invasive, the complications are substantial and well-documented:

1. Femoral Neck Stress Fractures

One of the most common and catastrophic complications of hip resurfacing is a fracture of the femoral neck—the very bone left behind to “preserve bone.” These fractures often require emergency conversion to a total hip replacement, which is far more complex and less predictable than doing the proper procedure in the first place.

2. Extensive Muscle Damage

Most resurfacing procedures are performed through posterior or lateral surgical approaches, which involve cutting through major muscle groups—including the gluteus maximus and the external rotators. This leads to longer recovery, more pain, and increased risk of dislocation post-surgery.

3. Metal-on-Metal Complications

Resurfacing implants are nearly always metal-on-metal. That means the two components grind against each other and release microscopic metal particles—cobalt and chromium—into the body. This can lead to metal toxicity, chronic inflammation, soft tissue destruction, and systemic health risks. Many of these implants have been pulled from markets worldwide due to these complications.

4. Higher Revision Rates

Across multiple large-scale studies and registry data, resurfacing shows higher failure and revision rates, especially in women and patients with smaller femoral heads. These failures often happen within just a few years of the initial surgery.

The Better Alternative: Anterior Total Hip Replacement

While hip resurfacing continues to fall out of favor, anterior total hip replacement has become the gold standard—especially in experienced hands.

What Makes the Anterior Approach Superior?

Muscle-Sparing Technique: The anterior approach goes between muscles rather than cutting through them. That means faster recovery, less pain, and a lower risk of dislocation.
No Metal-on-Metal Bearings: We use proven, safe materials like ceramic and polyethylene, eliminating the risk of metal toxicity.
No Femoral Neck Fracture Risk: Unlike resurfacing, anterior hip replacement removes the vulnerable femoral neck, replacing it with a durable, well-anchored implant.
Proven Longevity: Modern implants can last 30+ years in the vast majority of patients.
Faster Recovery: Most patients are walking the same day and returning to daily activities in just a few weeks.

At Palmetto Bone and Joint, we’ve seen firsthand how anterior hip replacements transform lives—with fewer complications and greater long-term success.

Why Do Some Surgeons Still Perform Hip Resurfacing?

Given all the evidence, you might ask: why is hip resurfacing still being offered at all?

Unfortunately, the answer often comes down to money—not medicine.

Many of the surgeons still performing hip resurfacing receive royalty payments or financial incentives from implant manufacturers. These relationships may have started years ago when they helped design or promote resurfacing systems. As a result, they’re financially rewarded every time they implant one of these devices.

We find this deeply concerning.

When a surgeon chooses a riskier procedure because it comes with a check from a device company, that’s not innovation—that’s a conflict of interest. Patients deserve care driven by outcomes and ethics, not royalties.

Patient Care Should Always Come First

At Palmetto Bone and Joint, we do not accept financial incentives that compromise our judgment. We perform procedures and recommend treatments based solely on what is safest, most effective, and backed by evidence.

If you or a loved one has been told hip resurfacing is the best option, we strongly encourage you to seek a second opinion—especially if it’s being sold as “new,” “better for younger patients,” or “more natural.” These claims are not supported by long-term data.

Conclusion

Hip resurfacing may sound appealing on paper, but in reality, it exposes patients to higher risk, more complications, and more revisions than necessary. Anterior hip replacement offers superior safety, function, and durability—without the ethical gray areas of industry-backed procedures.

Your hip surgery is a once-in-a-lifetime decision. Don’t let it be compromised by outdated techniques or someone else’s financial gain.

Choose better. Choose proven. Choose ethical care.
Choose anterior hip replacement with the experts at Palmetto Bone and Joint.

To schedule a consultation or learn more about our approach to hip care, call us today or visit our website.
📞 803-941-8095
🌐 www.PalmettoBoneandJoint.com