What Are the 3 Types of Hip Replacement Surgery?
The 3 types of hip replacement surgery are total hip replacement, partial hip replacement (hemiarthroplasty) and hip resurfacing. The difference comes down to how much of your hip joint is replaced: both the ball and socket, the ball only, or a metal cap over the ball with a new socket lining.
Most people who need a new hip have a total hip replacement, usually because of arthritis. Partial replacement is mainly used to repair a broken hip in older adults, and resurfacing is offered only to a small group of younger, active patients with strong bones.
Below, we explain each of the types of hip replacement surgery in plain terms: who it suits, what the operation involves, how surgeons decide between them, and what recovery and risks look like. It should help you go into your appointment knowing which questions to ask.
What Is Hip Replacement Surgery?
Hip replacement surgery (hip arthroplasty) removes the damaged parts of your hip joint and replaces them with artificial parts made of metal, ceramic or medical-grade plastic. It is mainly done for osteoarthritis, rheumatoid arthritis, osteonecrosis and hip fractures (NewYork-Presbyterian).
Your hip is a ball-and-socket joint. The ball (femoral head) sits at the top of your thigh bone and fits into a cup-shaped socket (acetabulum) in your pelvis. The types of hip replacement surgery differ mainly in which of these two parts the surgeon replaces.
Doctors usually suggest surgery once other treatments stop working, typically when:
- hip pain makes walking, climbing stairs or getting dressed difficult
- pain keeps you awake or continues when you rest
- stiffness limits how far you can move your leg
- painkillers, physiotherapy and activity changes no longer give enough relief
The 3 Types of Hip Replacement Surgery at a Glance
Here's a quick side-by-side look at the 3 types of hip replacement surgery before we go through each one. Treat it as a general guide, as your surgeon will base the final choice on your scans and examination.
| Type | What's replaced | Usually suits | Main use | Main limitation |
|---|---|---|---|---|
| Total hip replacement | Ball and socket | Adults of most ages with advanced joint damage | Arthritis, osteonecrosis, some fractures | Biggest operation of the three |
| Partial hip replacement | Ball only; your own socket stays | Older or frail adults | Displaced femoral neck fractures | Not suited to arthritis; may not last as long |
| Hip resurfacing | Ball trimmed and capped; socket lined | Men under about 60 with strong bones | Arthritis in young, active patients | Risk of neck fracture and metal-ion reactions; offered in few centres |
Total Hip Replacement: The Most Common Type
Of the 3 types of hip replacement surgery, total hip replacement (total hip arthroplasty) is done most often (NewYork-Presbyterian). It replaces both the ball and the socket, so it treats damage on both sides of the joint.
What Gets Replaced
The surgeon removes the worn femoral head, fits a stem inside the thigh bone and lines the socket with an artificial cup. The materials are chosen to suit your age, bone strength and how active you are.
| Implant part | Where it goes | What it does |
|---|---|---|
| Stem | Inside the thigh bone | Anchors the new joint to your femur |
| Ball (femoral head) | On top of the stem | Replaces your worn ball; made of metal or ceramic |
| Cup | In the pelvic socket | Replaces the damaged socket surface |
| Liner | Inside the cup | Gives a smooth surface for the ball to move against; usually polyethylene (medical-grade plastic) or ceramic |
Who Is It For?
Total hip replacement is usually recommended for:
- moderate to severe osteoarthritis affecting both the ball and socket
- rheumatoid arthritis and other inflammatory types of arthritis
- osteonecrosis, where the femoral head loses its blood supply
- some hip fractures in people who are otherwise fit and active
The operation usually takes one to two hours. Many people go home the same day, while others stay in hospital for one or two nights (NewYork-Presbyterian).
Pros, Cons and How Long It Lasts
Benefits: less pain, easier walking, better sleep and long-lasting results for most people.
Drawbacks: it's major surgery, with a small risk of infection, blood clots and dislocation, and the implant can wear or loosen over many years.
You may have heard that a new hip lasts 10 to 15 years. That figure is out of date. A large 2019 registry analysis found that nearly 58% of hip replacements were still working after 25 years (Healthline), and today's implants use better materials. Younger, very active people put more load on the joint for longer, so they're more likely to need a second operation later in life.
Partial Hip Replacement (Hemiarthroplasty): Mainly for Hip Fractures
A partial hip replacement replaces only the ball of the joint and leaves your natural socket in place (Penn Medicine). It's mostly done to treat a broken hip (NewYork-Presbyterian).
Why It's Used After a Hip Fracture
When the femoral neck (the narrow section just below the ball) breaks and the pieces shift, the blood supply to the ball is often damaged. The bone may not heal properly and can collapse. If the socket is still healthy, replacing just the ball is a quicker, simpler fix.
Your surgeon may suggest it if:
- you're older and have a displaced femoral neck fracture
- you're frail or in poor general health (NHS)
- you're less active and a shorter operation is safer for you
Recovery is usually quicker than after a total hip replacement, but the implant doesn't usually last as long (NHS).
Why It's Rarely Used for Arthritis
Arthritis normally wears down both the ball and the socket. A partial replacement leaves your own socket in place, so any worn cartilage there stays and the pain often carries on. Over time, the new ball can also wear the natural socket, which may mean converting to a total hip replacement later. That's why people with significant arthritis are usually offered a total replacement instead, even after a fracture.
Hip Resurfacing: The Bone-Preserving Option
In hip resurfacing, the femoral head isn't removed. The surgeon trims it, covers it with a smooth metal cap and lines the socket with a metal shell (AAOS patient information via Shoreline Orthopaedics). Because more of your thigh bone is kept, a later revision to a total hip replacement can be easier.
Who May Qualify, and Who Shouldn't Have It
The best candidates are generally men under 60 with a larger frame and strong, healthy bones (Shoreline Orthopaedics).
| May suit you if you... | Probably not suitable if you... |
|---|---|
| Have strong, dense bone | Have osteoporosis or thin bones |
| Are active and want to keep more of your own bone | Have a small femoral head or a significant hip deformity |
| Have healthy kidneys | Have kidney disease, since the kidneys clear metal ions from the blood |
| Can commit to long-term follow-up | Have a known metal allergy or sensitivity |
Age alone doesn't decide it. Your surgeon will look at your anatomy, bone strength and medical history.
Benefits and Drawbacks
Benefits: more natural bone is kept, the larger ball can feel stable, and more bone is left if you need another operation later.
Drawbacks: the femoral neck can fracture, especially in weaker bone, and the metal-on-metal surfaces can release tiny metal particles (ions) that cause pain, swelling or tissue reactions in some people (Shoreline Orthopaedics). Concerns about metal debris mean resurfacing has largely fallen out of favour in many hospitals (NewYork-Presbyterian).
Resurfacing is the hardest of all the types of hip replacement surgery to qualify for, and results depend heavily on how many the surgeon has done.
Questions to Ask Before Choosing Resurfacing
- Which implant will you use, and how has it performed in national joint registries?
- Is my bone strong enough to support the femoral neck?
- Will I need metal-ion blood tests or scans afterwards, and how often?
- How many resurfacing operations do you do each year?
Surgical Approaches: Anterior, Posterior and Lateral
The approach is simply the route the surgeon takes to reach your hip. It isn't one of the types of hip replacement surgery, and any type can be done through different incisions depending on the surgeon's training and your needs (NewYork-Presbyterian).
| Approach | Incision | Possible advantages | Points to discuss |
|---|---|---|---|
| Anterior | Front of the hip | Works between muscles rather than through them; may allow a quicker early recovery | Can cause thigh numbness; less suited to complex anatomy or revisions |
| Posterior | Back of the hip | Gives a wide view of the joint; useful for complex cases and revisions | Some soft tissue is detached and repaired; movement precautions are common early on |
| Lateral | Side of the hip | Good access with a stable soft-tissue repair | Involves the hip abductor muscles, which may cause a temporary limp |
Smaller, minimally invasive incisions are possible with each approach, but they aren't suitable for everyone (NHS).
Which Approach Is Best?
No single approach is best for everyone, and research hasn't settled on one as clearly better. For most people, a surgeon who regularly uses a particular approach matters more than which one it is. Ask your surgeon:
- Which approach do you recommend for my hip, and why?
- How often do you use it?
- What movement precautions will I need afterwards?
Robotic-Assisted, Bilateral and Revision Hip Replacement
You'll probably hear these terms during your consultation. They aren't extra types of hip replacement surgery. They describe how the operation is done, whether both hips are treated, or whether an older implant is being redone.
Robotic-Assisted Hip Replacement
A robot doesn't do the operation. Your surgeon stays in control and uses a 3D plan, usually based on a CT scan, and a robotic arm to guide bone preparation and implant placement. A 2025 review of 38 studies found that robotic assistance placed the socket more accurately and had fewer complications. However, patients didn't report better results, revision rates were similar, and operations took longer (Bensa et al., Journal of Arthroplasty).
If it's offered, ask whether it actually helps in your case, and whether it means extra cost or a CT scan beforehand.
Bilateral (Both Hips) Replacement
If arthritis affects both hips, they can be replaced in one operation or in two separate ones.
| Both hips in one operation | Two separate operations | |
|---|---|---|
| Anaesthetics and hospital stays | One | Two |
| Surgery | Longer and more demanding | Shorter each time |
| Recovery | One recovery period, but harder at first | Two recovery periods |
| Usually suits | Fit people without major heart or lung problems | People for whom a long operation is riskier |
If the hips are done separately, a Johns Hopkins specialist advises waiting at least six weeks between operations to lower the risk of blood clots (UPI/HealthDay).
Revision Hip Replacement
Revision surgery replaces some or all of an earlier implant. The usual reasons are loosening and wear, infection, repeated dislocation and fractures around the implant (AAOS OrthoInfo).
It's a longer, more complex operation than the first one and often needs special implants to make up for lost bone (AAOS OrthoInfo). An infected implant may need two operations, with a temporary antibiotic spacer in between.
How to Choose Between the Types of Hip Replacement Surgery
There's no single right answer. Your diagnosis usually matters most, followed by your age, bone strength and overall health.
| Your situation | Option usually considered | Why |
|---|---|---|
| Advanced hip arthritis | Total hip replacement | Both the ball and socket are worn |
| Displaced femoral neck fracture in an older or frail adult | Partial hip replacement | The ball is damaged, but the socket is often healthy |
| Fracture in an active adult, or with existing arthritis | Total hip replacement | Treats the fracture and any socket damage |
| Arthritis in a younger man with strong bones | Hip resurfacing (in selected centres) | Keeps more of the thigh bone |
Your surgeon will also weigh up:
- Age and activity: how active you plan to be and how long the implant needs to last
- Bone quality: strong bone may allow resurfacing, while osteoporosis usually rules it out
- General health: heart, lung and kidney health, diabetes and any previous hip surgery
- Your goals: whether you want to get back to walking, work, gardening or sport
Whichever of the 3 types of hip replacement surgery you're offered, it should make sense for your situation. Ask your surgeon to explain why they recommend it over the others.
Recovery and How Long a New Hip Lasts
Recovery differs across the 3 types of hip replacement surgery, but most people are up and walking with support within a day. A Johns Hopkins specialist puts early recovery at around two to four weeks on average, though your age, fitness, nutrition and other health conditions all play a part (UPI/HealthDay). Getting your full strength back with physiotherapy usually takes a few months.
What helps most:
- doing your physiotherapy exercises every day
- using your walking aid until your physiotherapist says you can stop
- following any movement precautions you're given, especially in the first few weeks
- keeping to a healthy weight to reduce strain on the new joint
Most new hips last a long time. Nearly 58% are still working after 25 years (Healthline), and newer implants are expected to do better.
Risks and Complications
Serious problems are uncommon, but all types of hip replacement surgery carry some risk:
- infection around the wound or the implant
- blood clots in the leg or pelvis
- dislocation, where the ball slips out of the socket
- loosening or wear of the implant over time
- a difference in leg length
- nerve or blood vessel injury
Your care team will usually use antibiotics, blood-thinning medicine, and early walking to lower these risks. Some risks depend on the procedure:
| Procedure | Risks to discuss with your surgeon |
|---|---|
| Total hip replacement | Dislocation, leg-length difference, long-term loosening or wear |
| Partial hip replacement | Wear of your natural socket, which may cause pain and need conversion to a total replacement |
| Hip resurfacing | Femoral neck fracture and reactions to metal ions |
| Bilateral (same day) | Greater blood loss and a tougher early recovery |
| Revision surgery | Higher risk of infection, instability and bone loss than a first operation |
Contact your care team promptly if you notice:
- redness, warmth, swelling or discharge at the wound that's getting worse
- a fever or hip pain that's getting worse
- pain or swelling in your calf
- sudden breathlessness or chest pain. Call emergency services straight away.
FAQs About the Types of Hip Replacement Surgery
1. What are the 3 types of hip replacement surgery?
Total hip replacement (ball and socket replaced), partial hip replacement (ball only) and hip resurfacing (ball capped, socket lined).
2. Which of the types of hip replacement surgery is most common?
Total hip replacement. It works well for advanced arthritis and for people of most ages.
3. Which type of hip replacement lasts the longest?
For most people, a well-placed total hip replacement lasts longest, often 20 to 25 years or more. Partial replacements generally don't last as long, and resurfacing results vary a lot by implant and patient.
4. Is partial hip replacement easier to recover from than total?
Often, yes, because it's a shorter operation. Recovery also depends on the fracture, your general health and how you get on with rehabilitation.
5. Is hip resurfacing better for young, active people?
It can be for some, mainly men under 60 with strong bones. It keeps more natural bone but carries a risk of femoral neck fracture and metal-ion reactions, so it isn't right for everyone.
6. Is anterior hip replacement a separate type?
No. Anterior, posterior and lateral are surgical approaches. Each of the 3 types of hip replacement surgery can be done through different approaches.
7. Is robotic hip replacement better?
It can place the implant more accurately, but studies haven't yet shown better patient-reported results or lower revision rates. It's a tool the surgeon uses during one of the standard types of hip replacement surgery rather than a type of its own.
8. What are hip implants made of?
A mix of metal (such as titanium or cobalt-chromium), ceramic and medical-grade plastic called polyethylene. Your surgeon chooses the combination based on your age, activity level and bone quality.
9. Can I choose which type of hip replacement I get?
You can share your preferences, but the recommendation depends on your diagnosis, scans, bone quality and overall health. Ask your surgeon to explain why they suggest one option over another.
Conclusion: Which of the 3 Types of Hip Replacement Surgery Is Right for You?
For most people with arthritis, a total hip replacement is the answer. Partial replacement is mainly for hip fractures in older adults, and resurfacing suits a small group of younger patients with strong bones. Knowing the types of hip replacement surgery will help you ask better questions, but only a specialist who has examined you and seen your scans can tell you which one is right.
References:
- Hip Replacement Surgery, NewYork-Presbyterian
- Hip Replacement Surgery, Columbia Orthopedics at NewYork-Presbyterian
- How a hip replacement is done, NHS
- Hip replacement surgery, Penn Medicine
- Hip Resurfacing, Shoreline Orthopaedics (AAOS patient education)
- Revision Total Hip Replacement, AAOS OrthoInfo
- Robotic-assisted THA: systematic review and meta-analysis, Bensa et al., Journal of Arthroplasty (2025)
- Expert shares what to expect after hip replacement surgery, UPI/HealthDay
- How long does a hip replacement last, Healthline
