Hip resurfacing has been around for over 12 years, but in the early days, it was really only done by ‘enthusiasts’, specialist hip surgeons who saw its potential. We have seen a number of problems in recent years. In men there is a small risk of a fracture of the neck of the femur. This usually happens around 3-4 months after the operation at the time when the patient returns to work, or sports. It is a distressing complication, and requires another operation, but the outcome is usually excellent. Later failures (around 3-4 years after surgery) are more commonly seen in women. The femoral component (the ball part of the joint) can loosen, causing pain, clunking and a feeling of instability in the joint. This too requires surgery to sort out the problem. There are increasing reports of problems related to reactions to the metal constituents of the bearing. These usually present with increasing pain, and an ‘awareness’ of the joint. In some cases there is a large collection of fluid in the joint, and this can be associated with damage to the soft tissues around the hip. A recent study from Oxford, published in the Journal of Bone and Joint Surgery showed a significant difference in the incidence of this complication between men and women. In my own practice, I have had a similar experience, and stopped using resurfacings in women 3 years ago. If the situation is left untreated, the damage can be severe and this can make the subsequent operation very difficult. If you have a painful hip resurfacing, you must seek advice from your surgeon. You will need to have blood tests and a scan, and usually an aspiration of fluid from the hip. It’s likely that the resurfacing will have to be removed and a new hip replacement put in. In the last few years I have done this procedure many times and the outcome is usually very good. If you would like to find out more, please get in touch.