Total Hip Replacement vs Partial Hip Replacement vs Hip Resurfacing: Understanding the Differences

Here’s a simple breakdown of three common hip procedures: Total Hip Replacement, Partial Hip Replacement, and Birmingham Hip Resurfacing. This guide breaks down what each option involves, who it’s best suited for, and what to expect, so you can feel more confident when talking with your doctor or making a decision.

Total Hip Replacement

What It Involves

A total hip replacement (THR), also called total hip arthroplasty, involves removing the damaged bone and cartilage in both the ball (femoral head) and the socket (acetabulum) of the hip joint. These are replaced with prosthetic components—usually a metal or ceramic ball attached to a stem (inserted into the femur), and a plastic, ceramic, or metal cup secured in the pelvis.

The artificial joint mimics the natural movement of the hip, allowing for smoother motion and reduced pain. It is one of the most commonly performed orthopedic procedures worldwide.

Best For

This procedure is ideal for patients with advanced osteoarthritis, rheumatoid arthritis, hip dysplasia, or joint deterioration due to trauma or long-term wear and tear. It's especially suitable when the pain interferes significantly with daily life, such as walking, sleeping, or standing.

Many patients undergoing THR are in their 60s or older, but younger individuals with severe joint damage may also be candidates.

What to Expect

• Longevity: Most joint replacement surgery last 15–25 years, though many exceed that with proper care.

• Recovery: Full recovery typically takes 3–6 months, depending on age, fitness, and adherence to physical therapy.

• Mobility: Significant improvement in mobility and pain reduction is usually achieved, leading to better quality of life.

• Risks: Includes infection, dislocation, blood clots, and wear over time—but serious complications are rare with modern techniques.

  
  

This surgery has a strong track record of success and is performed routinely in both public and private hospitals. Advances in surgical techniques, such as minimally invasive approaches and enhanced recovery protocols, have further improved outcomes.

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Partial Hip Replacement

What It Involves

A partial hip replacement (also called a hemiarthroplasty) involves replacing only the femoral head (ball of the joint), while the natural socket remains intact. This approach is generally less invasive than total joint replacement and is used when only the femoral component is damaged.

In most cases, a metal or ceramic ball is attached to a stem inserted into the thigh bone. There is no alteration to the acetabulum (socket), which means surgery time is shorter and less bone is removed overall.

Best For

This type of procedure is commonly used for older adults, especially those who suffer a hip fracture due to a fall or osteoporosis. Because the joint damage is limited to the femoral head, there's often no need to replace the entire hip structure.

It's not typically used for patients with arthritis, as the socket often becomes worn in those cases and would still cause discomfort.

What to Expect

1. Surgery and Hospital Stay: The surgery usually takes 1-2 hours with a hospital stay of 2–4 days.

2. Recovery: Healing time may be quicker than total replacement, though patients still need physical therapy.

3. Durability: While effective, partial replacements may not last as long and might feel less stable over time if the socket deteriorates.

4. Limitations: Because only one part of the joint is replaced, there may be slightly more friction or uneven wear compared to a full replacement.

Patients can still return to normal activities, such as walking and light exercise, but high-impact activities may be discouraged. Long-term results depend on the health of the remaining joint structure.

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Hip Resurfacing

What It Involves

Hip resurfacing is a bone-conserving procedure where the femoral head is trimmed and capped with a smooth metal covering. A corresponding metal cup is placed into the hip socket (acetabulum), similar to a total replacement, but the femoral bone is largely preserved.

This technique keeps more of the natural anatomy intact, particularly the femoral canal, which can be beneficial if a future revision surgery is required.

Best For

Hip resurfacing is typically recommended for younger, physically active men, often under age 60, who want to maintain a high level of activity and delay a full joint replacement surgery. Men tend to have larger and denser bones, which lowers the risk of complications seen with this technique.

It is not recommended for patients with osteoporosis, kidney problems, or metal allergies. Women are less frequently considered candidates due to smaller bone structure and higher complication rates.

What to Expect

• Preserved Bone: More natural bone structure is maintained, which may make future surgeries easier.

• Natural Feel: Patients often report a more natural feel and wider range of motion, especially useful for athletes or active individuals.

• Recovery: Slightly faster return to sports or active hobbies, but similar rehab to total replacement.

• Risks: Concerns remain about metal-on-metal wear, which in some patients has led to metal ion build-up in the bloodstream and surrounding tissues. This has caused the procedure to fall out of favor in some regions.

Despite those concerns, for the right candidate, hip resurfacing can offer excellent function and delayed need for full replacement. Close monitoring and regular follow-up are essential after the surgery.

Estimated Annual Hip Procedure Volumes in New Zealand: 2010 vs 2023

To give a clearer picture of how joint replacement surgery has evolved in New Zealand, let’s look at the estimated number of procedures performed annually. These figures reflect data trends from national joint registries, health reports, and hospital observations. The numbers also help highlight which procedures are most commonly used today — and how that has changed over time.

Procedure Type	~2010 Annual Volume (NZ)	~2023 Annual Volume (NZ Estimate)	Change %
Total Hip Replacement (THR)	~6,800–7,200	~9,500–10,000	+35–45%
Partial Hip Replacement (PHR)	~800–1,000 (10–15% of THR)	~1,200–1,500	+30–50% (roughly)
Hip Resurfacing	<200 (<2% of THR)	~100 or fewer (<1%)	Stable / niche market

Why Has Total Hip Replacement (THR) Become So Popular?

The most significant growth has been in Total Hip Replacements, and for good reason. THR now represents the overwhelming majority of hip surgeries across New Zealand, with nearly 10,000 procedures annually. Here’s why it has become the most widely accepted and trusted option:

✅ Reliability & Longevity

Modern total hip implants are built to last. Thanks to advances in prosthetic design, materials (like ceramic-on-polyethylene), and implant fixation methods, patients are seeing longer-lasting results — with many implants lasting well over 20–25 years. This is especially reassuring for younger patients who previously may have faced revision surgery within 10–15 years.

✅ Wider Suitability

Total joint replacement is effective for treating a broad range of conditions, including:

• Osteoarthritis

• Rheumatoid arthritis

• Avascular necrosis

• Congenital hip disorders

• Trauma or fracture with joint damage

Its wide applicability means it’s often the default surgical recommendation for those with moderate to severe hip joint problems.

✅ Clinical Outcomes

Patient outcomes for THR are generally very positive. Most patients report:

• Marked reduction in pain

• Improved ability to walk, climb stairs, and perform daily activities

• Better overall quality of life

Surgical refinements, such as anterior approach techniques and robot-assisted placement, have further increased precision and reduced complications.

✅ Surgeon Training & Experience

Since THR is the most performed hip procedure, it also receives the most surgical focus in both training and practice. Most orthopedic surgeons are highly experienced in this operation, making it a safe and dependable choice for most patients.

Recovery Expectations

Recovery time varies slightly depending on the type of surgery, the patient's overall health, and the specific surgical technique used. Here's a general breakdown:

• Hospital Stay: Typically 3 to 5 days post-op. Some private centers and enhanced recovery programs may allow same-day or overnight discharge.

• Initial Mobility: Patients usually begin walking (with assistance) within 24–48 hours. Physical therapy starts early to promote circulation and build strength.

• Full Recovery: Most people can resume regular daily activities within 6 to 12 weeks, although high-impact sports may require a longer recovery period or may not be recommended at all.

  
  

Proper rehabilitation, exercise, and follow-up care are critical in achieving the best possible outcome.

How Long Do Implants Last?

The lifespan of a hip implant is influenced by factors such as the patient’s age, activity level, body weight, and the type of prosthetic materials used. Here's how the different types compare:

Total Hip Replacement (THR)

• Lifespan: 15–25 years, with many lasting 30+ years.

• Why: Modern materials (e.g., ceramic heads, cross-linked polyethylene cups) wear down more slowly and reduce inflammation or loosening.

• Best For: All ages, particularly those with severe or widespread joint damage.

  
  

Partial Hip Replacement (PHR)

• Lifespan: 10–20 years.

• Why: Only the ball is replaced, leaving the natural socket to bear some of the load. If the socket deteriorates over time (common in arthritis), revision may be needed.

• Best For: Older, less active individuals who require faster recovery and don’t place high demands on their hips.

  
  

Hip Resurfacing

• Lifespan: 15–25 years, possibly more in ideal cases.

• Why: Designed for younger, active patients wanting bone preservation. However, it comes with risks, especially due to metal-on-metal wear, which has led to complications in some cases.

• Best For: Select younger male patients with strong bone density and no metal sensitivities.