Minimally invasive (mini incision) THR

What is it? A technique that can be used with various implants using shorter incisions than in a THR, so less muscle is cut and reattached. Incisions may be made in the front (direct anterior approach), side or back of the hip.

Best candidates: Active people younger than 50.

Pros: Less pain, less time in the hospital, and quicker recovery than with conventional hip replacement.

Cons: Dr. Barrack says these procedures – especially the direct anterior approach – are difficult and have higher complication rates. Correct placement of the artificial hip is more important than incision size, he adds.

Hip resurfacing

What is it? The hip socket is replaced by a metal cup, and the damaged hip ball is reshaped and capped with a metal, dome-shaped prosthesis.

Best candidates: Men younger than 60, especially athletes or those with physically demanding jobs.

Pros: Ability to participate in high-impact sports and activities that require flexibility, such as martial arts and yoga. Conserving the thighbone may make future hip surgery easier.

Cons: Higher complication rate than conventional implants, and the metal-on-metal system poses the same risks as other all-metal hip replacement systems. It’s not recommended for people with osteoporosis, kidney disease or diabetes.

Hip revision

What is it? Surgery to remove a failed, infected or worn-out implant and replace it with a new one.

Best candidates: People with a damaged artificial hip. Implants can last 20 years or longer, but those who get them as young adults may eventually need a revision.

Pros: Pain relief and improved mobility, strength and coordination.

Cons: Hip revisions are more complex and less successful than the original replacement surgery, which removes a significant amount of bone, making it hard to anchor a new implant. Removing the old implant is technically challenging, and possible complications include a higher fracture risk after surgery, twice the risk of dislocation, and uneven leg lengths.