Hip resurfacing removes less bone and therefore makes future revision surgery easier
Hip resurfacing involves reshaping the ball of the hip joint, rather than removing it, and so less bone is indeed removed from the femoral side. However, because the diameter of the socket component must be at least 6mm larger than the diameter of the ball (femoral) component, it is not unusual to put in a larger cup than would have been necessary if a total hip replacement had been performed. Therefore, the same or more bone may have been removed from the socket side.
Implants should never be chosen for ease of revision. They should be chosen based on their durability and the needs of individual patients. Failure rates of hip resurfacing should be very low provided an appropriate implant is inserted correctly into an appropriate patient. Even if revision surgery is required, ‘re-do’ hip replacement surgery is no longer the unpredictable, dangerous operation it once was. Implants and techniques have advanced immensely making it a highly predictable procedure in the hands of specialist revision surgeons.
Whilst revision of the resurfacing head component is easier than revision of a stemmed total hip replacement, revision of the latter is still a routine procedure. Initially it was felt that if there was an early failure of the femoral component, then this should be treated by leaving the socket component and replacing the femoral component with a standard stemmed hip replacement and a large metal ball. Due to problems with large diameter metal on metal hip replacements, it is now generally felt appropriate to change both components and revise to a ceramic on ceramic bearing. Removing a well fixed resurfacing socket leads to further loss of bone and the use of an even bigger socket.
Hip resurfacing is less invasive than total hip replacement
Whilst hip resurfacing may remove less bone, the operation itself is no less invasive than standard total hip replacement. In fact, additional releases and a longer scar may be required to mobilise the femur sufficiently to gain access to the socket.