Birmingham hip resurfacing offers an effective long-term alternative to total hip replacement, especially for athletic men in their 30s to 50s.
Patients who underwent BHR were three times more likely to resume high-impact sports like basketball and tennis compared to those with total hip replacements.
With a 93% follow-up rate and less than 4% needing additional procedures even 15 years later, BHR proves both durable and reliable for the right candidates.
Staying physically active as you age is highly recommended. However, whether on the basketball court, tennis court, or a weekend bike trail, the wear and tear on joints can be a painful price to pay.
And when it comes to aging athletes, that price often comes in the form of osteoarthritis, especially in the hips. Traditionally, a total hip replacement meant the end of high-impact athletic endeavors. But new long-term research is offering hope — and a second wind — to those not ready to hang up their cleats just yet.
A recent study from Washington University School of Medicine in St. Louis highlights the impressive longevity and athletic outcomes associated with Birmingham hip resurfacing (BHR), a specialized surgical procedure that’s helping patients return to — and maintain — active lifestyles years after surgery. The findings, published in The Journal of Bone and Joint Surgery, show that for the right patients, BHR can outperform total hip replacements in preserving mobility, function, and athletic capability.
High impact, low limitations
Dr. Robert Barrack, professor of Orthopaedic Surgery at WashU Medicine, led the study, which tracked 224 patients aged 35 to 59 who underwent hip resurfacing between 2006 and 2013. An impressive 93% of the patients were still actively engaged in sports, on average, 14 years post-surgery.
“Compared with a total hip replacement, three times as many patients who had hip resurfacing successfully returned, 5 to 10 years later, to running and cutting sports — those requiring rapid turns and shifts, such as basketball and tennis,” said Barrack.
That’s not just a statistical victory — it’s a life-changing one for those for whom physical activity is more than just a hobby.
Form, function and future movement
Unlike total hip replacements, which involve removing the top of the thigh bone and replacing it with a prosthetic, hip resurfacing reshapes and caps the femoral head with a metal alloy. The socket in the pelvis is similarly capped. This method better preserves the original joint structure, allowing for more natural movement and even distribution of weight, both critical for maintaining an active lifestyle.
But the procedure isn’t for everyone. Due to the size of the metal cap, BHR is generally recommended for middle-aged men with strong bone density. Women, whose femoral bones are often too small to accommodate the implant, are usually steered toward other solutions. Precision is key: improper alignment can result in elevated metal ion levels, though Barrack's complication rate of under 4% rivals or exceeds that of standard hip replacements.
One of the most compelling testimonies comes from Jason Cutter, a 50-year-old athlete and home remodeler who underwent hip resurfacing in early 2024. After years of discomfort that he attributed to age and job-related strain, Cutter turned to his hockey league friends — many of them former pros — who steered him toward Barrack.
Three months after the procedure, Cutter was back on the ice. “I’m squatting, I’m doing all my leg exercises. I’m stretching — I feel fantastic,” he said.
For Barrack, these success stories are not outliers but rather the result of a commitment to patient care and surgical precision. His team’s ability to follow up with nearly all of their patients, up to 18 years post-op, underscores the durability and viability of BHR for those who simply aren’t ready to slow down.