Hip Talk at Surface Hippy

There has always been a lot of talk about robotic surgery being better than manual surgery for hip resurfacing.  I have talked with many experienced hip resurfacing surgeons at conferences and most say the very experienced hands and minds of the excellent hip resurfacing surgeons is better than a robotic placement.  Hip resurfacing is more of an art than just skill.  Components must be placed at the proper angles for a long term successful outcome. So most the top surgeons do not use robotic assistance.

I even Googled the subject and found a similar response which I post here:  Robotic-assisted hip resurfacing offers enhanced precision for implant placement, potentially preserving more bone and improving long-term outcomes, but
surgeon experience is paramount, with many experts from sites like Surface Hippy stressing that technology is a tool, and a highly skilled, experienced surgeon (especially for complex hip resurfacing) often yields superior results over a less experienced surgeon using a robot. While robots improve accuracy, studies show no significant difference in patient-reported outcomes between robotic and manual total hip arthroplasty, highlighting that a surgeon's skill in choosing and executing the right approach is key. 

Benefits of Robotic Assistance (Generally for Hip Procedures):

• Greater Accuracy: Robots help with precise implant positioning (cup angle, leg length).
• Bone Preservation: Better accuracy helps keep healthy bone and tissue intact.
• Reduced Complications: Potential for fewer revisions and better long-term function. 

The Role of the Surgeon (Especially for Resurfacing):

• Precision is Critical: Hip resurfacing requires extremely high precision, more so than total hip replacement, notes Surface Hippy.
• Experience Matters Most: A surgeon's deep experience with the specific resurfacing technique is often cited as the single most important factor for success.
• Robots as Tools: Technology enhances, but doesn't replace, surgical expertise; an experienced surgeon using the robot (or manual methods) is generally preferred. 

The Verdict:
For hip resurfacing, an experienced surgeon (often one who does many resurfacing procedures) is generally considered more crucial than robotic assistance alone, as the surgery demands a high level of manual skill and judgment. Robotic tech adds value by improving consistency, but it's the surgeon's expertise in complex cases that truly dictates success in this specialized procedure. 


That was very similar to what I heard surgeons say.  There was a study teaching new doctors hip resurfacing with robotic assistance which Professor Cobb ran.  I will post that too, but I would always take a really experienced hip resurfacing surgeon before a newer surgeon using robotic assistance.  Just my opinion after have a hip resurfacing 20 years ago which is still perfectly good, never having any problems.  Here is a link to the Professor Cobb study:   https://surfacehippy.info/surgical-robot-pilot-study-in-uk/

Can I ask something?

@ocwa80 Answer: As soon as you are ready. I was in the same spot you are in. Feel free to ping me.

@ocwa80 This is a journey I went on as well (was roughly your age). I considered all options and spoke to all the major hip resurfacing surgeons. I narrowed my final two to Gross and Su. I honestly think you can't go wrong with either. I went with Dr Su for these reasons: 1\ Age - Dr Su is younger and will be available longer for my second hip, any revisions needed etc 2\ HSS: Is the #1 ranked orth hospital in the world. God forbid something went sideways I would be at HSS and in NYC, not South Carolina (no offense) 3\ NYC is close and easier for me to get to for follow up (I am in Boston). 4\ At the time I wanted cemented - so I could get back at it sooner, with no restrictions. I don't think this applies any longer. I am happy with Su, and it was a lot more expensive.

In case it helps the next person, I just started running again at 1-year post-op (doctors orders, no running for 1 year).  It was hard at first, the first 1/3-ish of a mile was a breeze, but then suddenly exhausting (gassed easily), muscles got sore and felt like I was pulling a parachute.  FF a few weeks and I did my first post-op 5k run (not a race) and felt great.  And more importantly, it feels like running is helping the hip become even stronger as it feels better during the day since I started running again. 

Hi Matt,

The THR hip has a bit more range of movement,  which helps for climbing, but they both feel the same for running - maybe the muscles around the BHR get a bit more sore after long runs.
The recent half-marathon went as well as it might. The first phalanx of faster runners happened to take the wrong turn after a mile, though, so several hundred of us took a course that was a quarter of a mile longer than the official route. My time at the finish was 2:02:16 which was disappointing but the County standards official has set a correction factor for those who were misled and my time becomes 1:59:59 on that basis - which is very acceptable. I was in expensive racing shoes however...

I just had my 5 year check and I am pleased to report that my results in regards to metal ion/Cobalt/Chromium where all as if I was a normal individual! I continue to participate in 10K races, I run every day up to 40 miles per week at the age of 69!

Quote from: petemeads on October 20, 2025, 08:40:07 AMHi. I was struggling with my hips from age 60 but left it to nearly 64 before biting the bullet. My BHR will be 11 years old next month, and my THR right hip will be 8.5 years.
I'm not sure that I would have qualified for a resurfacing if I had pursued it any earlier, and I too was worried about the longevity of the device. As it is, things have worked out very well, my devices have given me back the hills, climbs, parkruns and races that I needed to be 'me'.
I have a friend who had a BHR in 1998, still working well, so longevity not a problem (he's 80) and I have done over 400 5k parkruns on one or two artificial hips. I am booked in to race a half marathon on Sunday, hoping to beat last years 2:02 despite being a year older, looking forward to next year's age category of 75-79, there are races to be won!
In short, if you qualify, get it done.

You're doing spectacular!  Out of complete curiosity, how is running on the THR compared to the BHR? 

Based on my personal experience plus what I have read from others, I would expect quite a lot of improvement by 5 months.  Pain can be subjective, but certainly I would expect less pain plus improved ROM, not less.  If your doctor doesn't seem receptive to your complaints, maybe a second opinion from a different doctor would be beneficial. 

I am a 44yo woman who had a BHR done in May. My hip still hurts quite a bit and I have decreased ROM. It's been 5m and it's not any better. On top of that I developed what we now call my "bubble". Doc said pocket of fluid trapped by sutures and it'll resolve. Then at my next appointment it was probably just bursitis. But the thing is, she's grown. Like it's noticeable through my clothes. Has anyone else struggled with this? The pain and the bubble at 5 months out is not what I'd imagined when I chose resurfacing.