Concierge orthopaedics · UK
Private hip resurfacing in the UK, by a high-volume consultant.
A bone-preserving alternative to a total hip replacement for the right young active patient — BHR or Adept, an honest view on whether you are a candidate at all, and MHRA-standard lifetime surveillance built in from day one.
Why patients choose us
- 01
A high-volume resurfacing surgeon
Hip resurfacing is a narrow specialty. We introduce you to the small number of UK surgeons still doing it in real numbers — not a general hip surgeon dabbling in it.
- 02
Honest about selection
Most hips are better served by a standard replacement. If you are not a good candidate — female, small femoral head, wrong bone quality — we say so before you commit.
- 03
MHRA-standard lifetime surveillance
A metal-on-metal bearing means annual reviews, serum cobalt and chromium ions and MARS-MRI if you become symptomatic. We build that into the plan from day one.
Indicative pricing
What a private hip resurfacing costs in the UK.
Indicative ranges across our partner clinics. Send the details and we quote firm figures across two or three options.
In short
A BHR in our network: £14,000–£20,000, home in 1–2 nights.
| Procedure | Indicative range | Typical duration | Recovery / turnaround |
|---|---|---|---|
| Hip resurfacing (BHR — Smith & Nephew) | £14,000–£20,000 | 90–120 min | 1–2 nights |
| Hip resurfacing (Adept — MatOrtho, UK-made) | £13,000–£19,000 | 90–120 min | 1–2 nights |
| Consultant hip work-up (Xray + MRI + CT) | £1,200–£2,500 | Half-day | 3–5 days |
| Baseline serum cobalt & chromium | £120–£220 | 15 min | 7 days |
| MARS-MRI for symptomatic MoM hip | £700–£1,200 | 45 min | 3–5 days |
| Consultation only | £250–£450 | 30–45 min | Same visit |
Prices vary by clinic, by which surgeon does the case, by the implant chosen (BHR or Adept), and by the length of stay. NHS resurfacing is available in a small number of specialist centres. We come back with a firm quote within one working day.
The problem
The right surgeon, the right implant, the right patient.
Hip resurfacing has a narrow but real role in modern UK orthopaedics. The mistakes are all at the front end — a general hip surgeon dabbling in it, or the wrong patient being talked into a metal-on-metal bearing they should never have had.
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Are you actually a candidate?
Young active man with a large femoral head, good bone quality and non-inflammatory arthritis. We say so honestly — including when the answer is no.
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Which implant fits your hip?
BHR has the longest UK track record. Adept is a UK-made alternative. The right choice depends on your anatomy, not on what a surgeon has in stock.
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Who will follow you up for life?
A metal-on-metal bearing needs annual ions and clinical review for the life of the implant. Built in from day one, not an afterthought.
The journey
From enquiry to lifetime surveillance — what happens, in order.
One consultant from first message through the operation and into the annual reviews that follow — for the life of the implant.
Phase 1 · Before your procedure
Concierge, off-stage for you
Phase 2 · On the day
Theatre and 1–2 nights on the ward
Phase 3 · After
Rehab and annual review for life
- 01
Before
You tell us what is going on
A short, confidential form. Age, activity level, imaging so far, and what a general hip surgeon has already said.
- 02
Before
We come back with a recommendation
Within one working day: whether resurfacing is realistic for you, or whether a standard hip replacement is the better call, with an indicative price.
- 03
Before
Full work-up
Standing pelvic X-ray, MRI to check bone quality and rule out significant AVN, CT for femoral head sizing, and a baseline serum cobalt and chromium.
- 04
On the day
Admission and anaesthetic
Consultant anaesthetist review, spinal or general, tranexamic acid, antibiotic cover. A named consultant hip surgeon in theatre.
- 05
On the day
The procedure itself
90 to 120 minutes through a posterior or lateral approach. Femoral head preserved and capped, acetabular cup impacted uncemented, fluoroscopy for cup position.
- 06
On the day
One to two nights on the ward
Full weight-bearing from day one, physio-led rehab, DVT prophylaxis, and a check X-ray before discharge.
- 07
After
Rehab and lifetime surveillance
Driving at four to six weeks, sport including running at three to six months. Then annual clinical review and serum ion checks for life.
Typical end-to-end: 3–4 weeks from enquiry to procedure. Full sport return: 3–6 months.
When it helps
When hip resurfacing is the right operation.
The situations where a resurfacing genuinely earns its place — plus the red flag that means a standard total hip replacement is the safer call.
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Young active man with hip OA
Traditionally age under 65, ideally under 55, with a femoral head above 48–50mm and non-inflammatory osteoarthritis.
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Impact sport or manual work
A patient who wants to keep running, playing contact sport or return to heavy manual work — where a resurfacing offers a real advantage.
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Early AVN of the femoral head
Avascular necrosis with less than about 30% head collapse and preserved bone quality — some cases still suit a cap rather than a full replacement.
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Bone preservation matters to you
Keeping the femoral head and neck now makes a future revision to a total hip replacement more straightforward decades later.
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Anatomic offset and neck length
Resurfacing reproduces your own femoral offset and leg length more closely than a stemmed replacement — useful for cyclists and runners.
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Larger head, lower dislocation
A 46–56mm bearing gives a bigger range of motion, better kneeling comfort, and a dislocation rate below 0.5% versus 1–3% for a standard replacement.
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Second opinion after a THA offer
A general hip surgeon has offered you a total hip replacement and you want an honest view on whether a resurfacing is still on the table.
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Red flag: not for most patients
Female, small femoral head, osteoporotic, inflammatory arthritis, renal impairment or metal allergy — a standard replacement is safer and we will say so.
Procedure options
Resurfacing is one of several options.
The current UK implants, the two surgical approaches, and the surveillance tools that come with a metal-on-metal bearing.
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Birmingham Hip Resurfacing (BHR)
The Smith & Nephew implant with the longest UK National Joint Registry track record in properly selected patients. Hybrid fixation — cemented femoral cap, uncemented cup.
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Adept resurfacing (MatOrtho)
A UK-manufactured cobalt-chromium resurfacing, offered both cemented and uncemented on the femoral side. An alternative to BHR in specialist centres.
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Posterior approach
The commonest approach for resurfacing. Excellent exposure of the femoral head, short posterior hip precautions in the first few weeks.
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Direct lateral approach
An alternative that avoids the posterior capsule. No routine hip precautions, but a slightly higher risk of a limp in the first few months.
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Conversion to THA (later revision)
The main reason to preserve the femoral head — a later revision to a total hip replacement is more straightforward than revising a failed stemmed implant.
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MARS-MRI surveillance scan
A metal artefact reduction MRI to look for pseudotumour or fluid collections around a metal-on-metal bearing if you become symptomatic or your metal ions rise.
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Serum cobalt and chromium monitoring
A blood test — under 7 µg/L is reassuring, 7–20 needs closer follow-up, above 20 raises suspicion of an adverse reaction to metal debris.
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Consultation only
An honest discussion of whether resurfacing is realistic for your hip — or whether a standard replacement is the better operation. No obligation.
Our vetted UK network
A small panel of resurfacing surgeons, we picked them.
Consultant hip surgeons across London, Birmingham and the North of England who still do resurfacing in real numbers. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every surgeon in our network.
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Consultant hip surgeons doing resurfacing in real numbers, not general hip surgeons dabbling
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National Joint Registry outcomes above the ODEP benchmark for their chosen implant
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Full MHRA-compliant lifetime surveillance built in — annual ions, MARS-MRI on symptoms
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Honest about who should NOT have a resurfacing — women, small heads, poor bone quality
Safety and recovery
What to expect afterwards — honestly.
Hip resurfacing is a bigger operation than it sounds, and comes with a metal-on-metal caveat you should understand before you commit. The rewards — bone preservation, larger head, lower dislocation, return to sport — are real, but only in the right patient.
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Metal-on-metal caveat
A cobalt-chromium bearing releases small amounts of metal ions. Most patients are unaffected but a minority — around 1–5% at 5–10 years — develop an adverse reaction to metal debris.
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Femoral neck fracture 1–3%
Usually in the first two years, higher in women and in patients with reduced bone quality. Follow the weight-bearing and activity advice carefully in the first six months.
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Not for female patients
MHRA data and the National Joint Registry both show higher revision rates and higher ARMD rates in women. A standard total hip replacement is safer.
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Not for small femoral heads
Femoral heads below 48mm have higher wear, higher metal ion release and worse survival. Your CT will show whether your head is big enough.
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Annual surveillance for life
A clinical review and serum cobalt and chromium each year — under 7 µg/L is reassuring, 7–20 needs closer follow-up, above 20 raises suspicion and triggers a MARS-MRI.
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Full weight-bearing from day one
The implant is press-fit and mechanically stable from the outset. Most patients walk out the next morning, driving at four to six weeks.
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Sport comes back — with counselling
Running, cycling and contact sport are all realistic at three to six months. Pivoting and professional sport at six to nine months, after physio sign-off.
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Renal impairment matters
Metal ions are cleared by the kidneys. If you have significant renal impairment, or you are planning a pregnancy, resurfacing is not the right operation.
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Red flags after surgery
Fever, spreading redness at the wound, calf swelling, sudden groin pain or a new limp are all reasons to contact the clinic or A&E the same day.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever implant was used, the note the surgeon sends you keeps to the same shape.
A quiet reminder
Surgical language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Indication, implant and sizing
Why the operation was done, which implant was used (BHR or Adept), the femoral head diameter and the acetabular cup size.
- 02 Technique
Approach, anaesthetic and cement use
Whether it was done through a posterior or lateral approach, under spinal or general anaesthetic, and whether the femoral cap was cemented.
- 03 Findings
Bone quality, cup position and fluoroscopy
Notes on the femoral head bone quality, the acetabular cup inclination and version on fluoroscopy, and any incidental findings.
- 04 Impression
Rehab, follow-up and lifetime surveillance
Read this first: weight-bearing status, physio plan, when sport is safe, and the schedule for annual ion checks and clinical review.
Recognised by major UK insurers
Cover for hip resurfacing varies by insurer — most fund the operation when medically indicated in an appropriately selected patient. We confirm cover, and any implant-specific caveats, before booking.
Frequently asked
Everything we get asked about hip resurfacing.
Quick answers on selection, implants, metal-on-metal surveillance, and how much sport you can honestly get back to.
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Who is a good candidate for hip resurfacing in the UK?
Traditionally a man under 65, ideally under 55, with a femoral head above 48–50mm, non-inflammatory arthritis such as osteoarthritis or early avascular necrosis, preserved bone quality, and an active life — impact sport, manual work or cycling — where the advantages of a resurfacing over a standard replacement are worth the metal-on-metal caveat.
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Why is hip resurfacing not usually offered to women?
MHRA safety alerts and National Joint Registry data both show that women have higher rates of adverse reaction to metal debris and higher revision rates after resurfacing. Female femoral heads are also often too small — under 48mm — which increases wear and reduces bone stock preservation. A standard total hip replacement is the safer operation for almost all women.
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How is hip resurfacing different from a total hip replacement?
A total hip replacement removes the femoral head and puts a stem down the thigh bone. A resurfacing caps the existing femoral head with a metal shell and lines the socket with a matching metal cup. You keep your own femoral head and neck, which preserves bone for any future revision and reproduces your natural anatomy more closely.
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How much does hip resurfacing cost privately in the UK?
Roughly £14,000–£20,000 for a Birmingham Hip Resurfacing and £13,000–£19,000 for an Adept, including the implant, surgeon and anaesthetist fees, hospital stay and standard follow-up. Add £1,200–£2,500 for the full imaging work-up. NHS resurfacing is available in a small number of specialist centres.
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What is ARMD, and how likely is it?
ARMD stands for adverse reaction to metal debris — a soft-tissue reaction to cobalt and chromium particles from the bearing, sometimes forming a pseudotumour. In properly selected male patients with a large head, the risk is around 1–5% at 5–10 years. It is significantly higher in women and in patients with smaller femoral heads.
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What is the annual surveillance schedule after a MoM hip?
MHRA guidance is a clinical review and serum cobalt and chromium ion levels each year for the life of the implant. Under 7 µg/L is reassuring, 7–20 needs closer follow-up, and above 20 is suspicious for ARMD and triggers a MARS-MRI. The exact schedule is individualised to the implant and your symptoms.
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When can I get back to running and sport?
Full weight-bearing walking starts on day one. Cycling on a stationary bike at four to six weeks, driving at four to six weeks, running and impact sport at three to six months, and pivoting or professional sport at six to nine months, after physio sign-off.
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How long does a hip resurfacing last?
National Joint Registry data at ten years shows around 90–95% survival overall, and around 95% in men with a femoral head above 55mm — comparable to a standard replacement in that group. Survival drops to around 75–80% in women with heads below 48mm, which is why patient selection matters so much.
Related treatments
Looking for something else?
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Hip replacement
Total hip replacement — the standard operation for end-stage hip arthritis.
Learn more -
Hip preservation surgery
For younger hips before arthritis — impingement, labral tears, dysplasia.
Learn more -
Hip revision surgery
Revising a failed hip replacement or resurfacing.
Learn more -
All tests & procedures
Every test, scan and procedure we arrange.
Learn more
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