Have you heard of hip resurfacing? Hip resurfacing arthroplasty is an alternative to a total hip replacement and is a more bone conserving option. It has been carried out for nearly 30 years and instead of replacing the hip joint, it is a procedure to resurface the damaged hip joint. Due to being bone conserving, it is ideal for younger patients whose hip joint has been damaged by arthritis. Hip resurfacing tends to have a better recovery and allows patients to return to high level activities including high impact sporting activity.
Women haven’t been able to choose hip resurfacing as an option since 2012 because the inferior results of the metal implants due to the smaller size of their hip joint. Men with smaller femoral heads (the top part of the leg bone that forms the hip joint) also couldn’t choose hip resurfacing. A new implant using ceramic materials was awarded a CE mark in 2025 and Fria was the first female patient at ROH to undergo hip resurfacing.
Arthritis affects people in many ways, but for some, it’s an injury that brings the problem to light. Fria was on a walk when she twisted her leg. “It was like it did a 180̊ on me. I couldn’t walk for two weeks I was in so much pain, so I booked in to get it looked at and was sent for an X-Ray. I was then sent to an orthopaedic surgeon for an urgent referral.”
After an initial consultation, Fria was referred to consultant orthopaedic surgeon, Mr Shakir Hussain. Because of the severity of her osteoarthritis Fria was advised her options were either conservative management with physiotherapy and steroid injections, or surgery to either resurface or replace the hip joint.
What’s important differs for everyone
Resurfacing would provide greater mobility for Fria, but as it was a new procedure she needed time to consider her options. At 49 years old, Fria’s normal is being able to walk up to 15,000 steps a day, so being able to walk and do yoga was really important. She also prays five times a day, which means she needs to be able to bend down onto her knees. A total hip replacement could have reduced her ability to bend as much as she wanted to.
Fria explained: “I was very nervous about a replacement because it does limit you a bit, and resurfacing is new for women. Mr Hussain provided lots of links and literature and he asked me to go away to do my research. I had a few appointments where we discussed loads of questions and to be fair Mr Hussain provided all the information I wanted.”
“He reassured me, told me there was no pressure. Mr Hussain explained that as I was the first female to have this procedure at the ROH there is not yet strong evidence to determine the long-term outcome, but the short-term data from the research has shown favourable outcomes. So I made the decision that I would go ahead, because I wanted to get back out and about to normality without restrictions.”
Recovery after surgery is a journey
Fria is four months into her recovery and has found it challenging, but hopeful. She adds: “To be honest I think I underestimated the recovery. I was in tears every day for two months – I don’t know if it’s because I was so active before so my muscles are already quite tight, but I started seeing improvements after three months. I’m not back to where I was before the injury but I’m not limping like I was pre-surgery and overall I feel a lot better.”
“I have found recovery is slow and gradual, kicking in about three months rather than six weeks after surgery which is common for a hip replacement. But eventually you start to see changes overnight. Of course recovery will take time, physiotherapy is quite intense and my joints do feel tight but compared to where I was before surgery where I couldn’t move, sit or stand without pain, I’m much better. The pain was diabolic before.”
Goal-setting is key
Fria adds: “I use an app to monitor and track my progress for my physiotherapy which is really helpful. I have been told that because my muscles were already quite strong before the injury, they’re getting tight as I’m doing my physio exercises, but I’m determined to get back to where I was before I had my injury.”
Fria is looking to going back to work fully, where she is an inspector for Local Authorities which involves lots of walking and driving around the West Midlands. She’s also hoping to get back to yoga and being able to kneel properly so she can pray.
Consultant orthopaedic surgeon, Mr Shakir Hussain, concludes: “It is incredibly exciting to be able to offer this technology to female patients who, until now, have been deprived of the benefits of hip resurfacing. This is not just about replacing a joint—it is about restoring function, independence, and quality of life.
“My goal is to enable patients to return to what they love—whether that is sport, work, or daily activities such as prayer—without restriction. Ceramic hip resurfacing represents a major step forward in achieving that.”
Date: 1 June