If you are weighing total hip replacement vs hip resurfacing, you are likely at a meaningful crossroads in your care journey. Both procedures aim to relieve chronic hip pain and restore mobility, but they differ in technique, candidacy, and long-term considerations. Understanding those differences can help you arrive at your consultation better prepared and more confident. At Charlottesville Orthopaedic Center, our team provides honest, individualized guidance so you can make the decision that best fits your anatomy, activity level, and goals. We invite you to contact Charlottesville Orthopaedic Center to book an appointment and start that conversation.
What Is Total Hip Replacement?
Total hip replacement, also called total hip arthroplasty, is a well-established surgical procedure in which the damaged ball and socket of the hip joint are removed and replaced with prosthetic components. The femoral head is replaced with a metal or ceramic ball attached to a stem that fits into the femur, while the acetabulum is fitted with a prosthetic cup, often lined with polyethylene or ceramic.
Conditions Total Hip Replacement May Address
Total hip replacement may help patients experiencing significant joint deterioration due to osteoarthritis, rheumatoid arthritis, avascular necrosis, or post-traumatic arthritis. Research suggests this procedure can meaningfully reduce hip pain and improve function for patients who have not responded to conservative measures such as those described in our guide to arthritis and chronic joint pain relief. Candidates typically include older adults or patients with advanced joint damage. Results vary by individual, and your provider can help determine whether this approach suits your specific condition.
What Is Hip Resurfacing?
Hip resurfacing is a bone-conserving alternative to total hip replacement. Rather than removing the femoral head entirely, the surgeon trims and caps it with a smooth metal covering. The acetabular socket is similarly fitted with a metal shell. Because the femoral head is preserved, less native bone is removed during the procedure.
Conditions Hip Resurfacing May Address
Hip resurfacing may be appropriate for patients with hip arthritis who have strong, healthy bone stock and wish to preserve as much natural anatomy as possible. It is often considered for younger, more active patients who may require a revision procedure later in life, since preserving the femoral bone can make future revision surgery more straightforward. However, hip resurfacing is not suitable for all patients, including those with certain bone quality concerns, specific anatomical variations, or metal sensitivity. Individual results may vary, and a thorough evaluation is essential before determining candidacy.
Key Differences Between Total Hip Replacement and Hip Resurfacing
Category Total Hip Replacement Hip Resurfacing How It Works Femoral head removed; replaced with prosthetic ball and stem Femoral head trimmed and capped; acetabulum resurfaced Treatment Areas Entire hip joint replaced Joint surfaces reshaped with metal components Results Timeline Many patients notice improvement within weeks; full recovery typically takes several months Similar recovery arc; individual results may vary Implant Longevity Modern implants often last 15 to 20 or more years; results vary Long-term data still emerging; revision may be needed Recovery Structured rehabilitation; most patients resume daily activities within weeks Similar rehabilitation process; activity progression guided by surgeon Ideal Candidate Older adults, those with advanced joint damage or poor bone stock Younger, active patients with good bone quality and no metal sensitivity
A table can only capture part of the picture. One nuance worth understanding is that hip resurfacing carries a small but recognized risk associated with metal ion release from the metal-on-metal bearing surface, which your provider will weigh carefully against your individual health profile. Total hip replacement, meanwhile, involves a larger initial implant but benefits from decades of outcomes data and a broader range of bearing surface options. Your bone density, activity demands, age, and anatomical factors all influence which approach may be more appropriate for you. A personalized consultation is the most reliable way to assess which path aligns with your goals.
We encourage you to explore our orthopedic blog and resources for additional educational content on joint health and surgical options.
Ready to discuss your options with a specialist? Schedule a consultation at Charlottesville Orthopaedic Center today.
Which Is Right for You?
Choosing between total hip replacement and hip resurfacing is not a one-size-fits-all decision. Several factors guide a surgeon’s recommendation, and understanding each can help frame your conversation with your care team.
Total hip replacement may be the more appropriate choice if you are over 60, have significant bone loss or poor bone density, have a history of conditions that affect bone integrity such as avascular necrosis, or prefer a procedure with the longest track record of outcomes data. Patients who have already explored conservative options, including those detailed in our overview of hip and leg pain relief, and have not experienced adequate relief are often strong candidates for total hip replacement.
Hip resurfacing may be worth exploring if you are a younger, active patient, typically under 60, with strong bone stock, no metal sensitivity, and a desire to maintain a more anatomically natural joint for as long as possible. Active individuals who want to return to higher-demand activities should discuss realistic expectations with their surgeon, as activity guidelines differ by implant type.
At Charlottesville Orthopaedic Center, our team provides individualized recommendations based on imaging, health history, and your personal goals. Following surgery, our in-house physical therapy and rehabilitation program supports a structured, supervised recovery designed to help you progress safely. Individual results may vary.
Why Choose Charlottesville Orthopaedic Center?
At Charlottesville Orthopaedic Center, patients benefit from a practice that integrates surgical expertise with in-house physical therapy, creating a continuous care experience from evaluation through recovery. Our team, which you can learn more about on our meet our orthopedic team page, brings extensive experience across joint replacement surgery, sports medicine, and rehabilitative care.
Dr. David Nielsen, the founder of Charlottesville Orthopaedic Center, is a board-certified orthopedic surgeon with over two decades of surgical experience. He has served as Chief of Surgery and Chief of Orthopedic Surgery at Martha Jefferson Hospital, and as Chairman of the Board at what is now UVA Surgical Care Riverside. These leadership roles have given him a broad perspective on the full continuum of surgical care. Patients in Charlottesville, Virginia, and the surrounding region trust our practice to provide honest, compassionate guidance at every stage of their orthopedic journey.
Frequently Asked Questions
Is hip resurfacing more expensive than total hip replacement?
Cost varies based on your insurance plan, facility fees, implant selection, and other individual factors. Hip resurfacing implants sometimes carry a higher component cost, but total out-of-pocket expenses depend on your specific coverage and care needs. We recommend reviewing our insurance and billing information and speaking with our team before your consultation so there are no surprises. Individual cost circumstances vary.
Can total hip replacement and hip resurfacing be combined or staged?
These are distinct procedures addressing the same joint and are not performed simultaneously. However, if a hip resurfacing implant requires revision later in life, it can sometimes be converted to a total hip replacement. This is one reason some surgeons consider hip resurfacing advantageous for younger patients: preserving the femoral bone may make a future revision more manageable. Your surgeon will walk you through these long-term considerations during your evaluation.
How does recovery compare between the two procedures?
Both procedures involve a structured rehabilitation period of several months before full activity is resumed. Most patients begin walking with assistance within days of surgery. Physical therapy plays a central role in restoring strength and range of motion for both procedures. Recovery pace depends on age, overall health, and adherence to your rehabilitation plan. Individual results may vary, and your care team will develop a timeline suited to your specific needs.
What should I look for when choosing a provider for hip surgery?
Look for a board-certified orthopedic surgeon with extensive experience in joint replacement surgery and a transparent approach to discussing the risks and benefits of each option. Access to in-house rehabilitation is also a meaningful differentiator, as continuity of care from surgery through recovery can support better outcomes. Ask about the surgeon’s preferred implant systems, how they determine candidacy, and what their revision process looks like should complications arise.
Are there non-surgical options I should try before considering surgery?
Many patients benefit from conservative treatments before pursuing surgical intervention. Options may include physical therapy, activity modification, anti-inflammatory medications, and injections such as those described in our overview of joint injections for pain relief. Surgery is typically considered when these approaches no longer provide adequate relief and quality of life is significantly affected. Your provider can help determine where you are on that spectrum.
Take the Next Step Toward Hip Pain Relief in Charlottesville, Virginia
If you are ready to explore total hip replacement vs hip resurfacing with a knowledgeable orthopedic team, Charlottesville Orthopaedic Center is here to help. Our compassionate providers will take the time to understand your unique situation and outline all available options. Call us at call for details or book your appointment online today. Individual results may vary.
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View DetailsWhat Our Patients Say
“I went to Dr. Nielsen for a second opinion on a dislocated hand. My first surgeon recommended surgery without much consideration. A friend suggested Dr. Nielsen, who spent time reviewing my case and concluded that I only needed rehabilitation. He was right! He's an excellent doctor.”
I was impressed with the quality of service and the caring people throughout the visit, from the receptionist to the doctor seen. They truly care and are honest and professional.
The best ortho in the state. Got my son in right away and is a very caring crew. Professional and clean atmosphere. Would recommend to anyone.
We can’t recommend Dr. Nielsen and his team enough. They represent the best in medical care and kindness to others. They are truly excellent in providing healthcare services. With him, you will find a health partner, a supportive friend on your health journey, and continuous support in your pursuit of well-being.
Highly recommend Charlottesville Orthopedic Center for PT. They are the best! Very knowledgeable, detailed, patient, caring and they listen. I had shoulder and knee issues. Matt was my physical therapist and I would definitely go back if I ever need more therapy. Thank you so much for all your help.
Very responsive, same day service. Staff is knowledgeable, friendly, and thorough when communicating complex medical information.
Great place. The best group of people you could ask for. Knowledgeable and polite. #1
I was able to get a same day appointment after every other place I called turned me away. In the end, I was glad I got turned away elsewhere because I can’t imagine any other practice being more caring and understanding.
