If patients are looking for a hip replacement today, they quickly notice that medicine is on the verge of a small revolution. Just a few decades ago, hip replacement was associated with a lot of surgical effort, long hospital stays, and frequent complications. Today, hip arthroplasty is considered one of the most successful surgeries overall. Modern implants last for decades, and thanks to minimally invasive approaches , patients are often mobile again just a few days after surgery.

However, while these minimally invasive techniques have become the standard, an old concept is experiencing a surprising comeback: hip resurfacing. This procedure – often referred to as a resurfacing cap or cap prosthesis – aims to maximally preserve the bone. For a long time, this idea was burdened by serious complications, particularly due to metal wear.

Now the surface replacement is being discussed in a new form: no longer as a metal-on-metal prosthesis, but as a ceramic cap prosthesis. Ceramic has proven to be particularly low-wear and biocompatible in endoprosthetics. Could this be the solution to the problems of the past?

The crucial question, however, is: Can a ceramic surface replacement be implanted minimally invasively? For patients, it is now a matter of course that hip surgery should be performed through small, muscle-sparing approaches. This reveals a conflict: The principle of surface replacement requires a completely different surgical technique, which is hardly compatible with minimally invasive procedures.

In this article, we clarify:

• What exactly is hip resurfacing?
• Why was the technique discredited for so long?
• What does the new ceramic variant promise?
• What role do minimally invasive approaches play in modern hip surgery?
• Why are short-stem prostheses today the safe, bone-preserving, and truly minimally invasive solution?

In the end, you will learn why ceramic resurfacing sounds exciting, but is associated with significant disadvantages in practice – and where you can obtain a modern, minimally invasive hip prosthesis in Mainz / Rhein-Main .

2. What does hip resurfacing mean?

To understand why resurfacing is discussed so controversially, one must first understand the principle.

2.1 Definition: What is a Resurfacing Cap?

In classical hip replacement, the entire femoral head is removed. A prosthetic shaft is inserted into the femur, which is connected to a new femoral head ball. This ball then glides into an artificial acetabulum, which is implanted into the pelvis.

In surface replacement it is different:

• The natural femoral head remains largely preserved.
• Only the outermost layer of the bone is removed.
• Then a metallic or ceramic cap is placed over the femoral head and cemented or anchored.
• This cap forms the new joint surface with a corresponding acetabular cup.

In principle, it is a kind of "hip prosthesis-light" – the bone is largely preserved, and the anatomy of the thigh is hardly altered.

2.2 Objective: Maximum Bone Preservation

The main advantage of resurfacing lies in bone preservation. This is particularly appealing for younger patients (under 55 years) with a high life expectancy who may eventually require revision surgery.
The more bone preserved in the thigh, the easier it is to perform a subsequent prosthesis implantation.

2.3 Delineation from the classical hip prosthesis

• Standard hip prosthesis (straight stem): complete femoral head removed, long prosthetic stem anchored in the femur.
• Short stem prosthesis: Femoral head removed, but only short stem anchored in the proximal femur → bone-sparing, minimally invasive possible.
• Resurfacing (capping prosthesis): The femoral head remains intact, only a cap is placed on top.

Thus, hip resurfacing positions itself between conservative joint preservation (e.g., osteotomy) and classical prosthesis.

2.4 Historical appeal

The idea of replacing a hip joint in such a way that the bone remains intact fascinated orthopedic surgeons since the 1970s. It corresponded to the desire of many patients:

• change as little as possible in one's own body,
• at the same time become pain-free and mobile again,
• and in the event of a revision, keep all options open.

However, as we will see in the following chapters, the reality of surface replacement had significant drawbacks for a long time.

3. History of Surface Replacement – From Hope to Disillusionment

3.1 First attempts in the 1970s

The idea of not completely removing the femoral head, but only covering it with a prosthetic cap, emerged as early as the 1970s. The first models of the so-called surface replacement of the hip were tested using various materials at that time.

The concept was equally attractive to patients and surgeons:

• Maximum bone preservation – particularly valuable for young patients who have to live with the prosthesis for many decades.
• More natural anatomy – due to the preservation of the femoral neck, the original leverage ratios and muscle attachments remain largely intact.
• Easier revision – if the prosthesis needs to be replaced at some point, all options remain open because the bone in the thigh remains largely intact.

However, the first generations already had to struggle with significant problems: The anchoring of the caps was technically difficult, and the materials used at the time (e.g. Teflon or early metals) proved to be not very durable. Many implants loosened again after a few years.

3.2 The Renaissance in the 1990s and 2000s

After the initially disappointing start, the surface replacement experienced a comeback in the 1990s. This was mainly due to advances in metallurgy and prosthetic technology.

The British orthopedic surgeons Derek McMinn and Ronald F. Treacy developed the well-known Birmingham Hip Resurfacing (BHR) system. This was celebrated as a 'gamechanger'. Worldwide, interest in resurfacing arthroplasty grew rapidly – also in Germany.

Highlighted benefits:

• Young, active patients should remain physically active for longer.
• The natural movement sequence should be better preserved.
• Bone sparing should facilitate revisions.

Many clinics have adjusted their programs and offered hip resurfacing as a “modern alternative” to the classic hip replacement.

3.3 Metal-on-metal: The great hope

The special feature of this generation of cap prostheses was the material: They were based on metal-on-metal sliding pairs. This means: Both the cap on the femoral head and the socket in the pelvis were made of highly polished metal.

The hope was:

• Metal is supposed to be durable and resistant.
• The abrasion should be minimal.
• Large head sizes should reduce the risk of dislocation.

Initially, the results seemed promising. Thousands of patients worldwide received such metal prostheses in the early 2000s.

3.4 The problems became apparent quickly - metal wear

However, complications soon accumulated. After just a few years, the following problems became apparent:

1. Metal abrasion:
   With every step, the cap rubs on the socket. This creates tiny metal particles (cobalt, chromium, nickel) that enter the body.
2. Metallosis:
   These metal particles accumulate in the surrounding tissue, leading to inflammation, necrosis (tissue death), and pain.
3. Systemic metal ion load:
   Blood tests showed that patients with metal-on-metal caps had increased cobalt and chromium levels in the blood. This can potentially damage organs - from the kidneys to the heart.
4. Early loosening:
   Due to tissue damage, many prostheses loosened after just a few years. The planned durability of 15–20 years was far from being achieved.

3.5 Known scandals – the ASR example

Particularly notorious was the ASR system of the manufacturer DePuy (a subsidiary of Johnson & Johnson). This metal-on-metal system had to be recalled worldwide in 2010 after thousands of patients suffered severe complications.

The consequences:

• Numerous revision surgeries were necessary.
• There were global class-action lawsuits and billion-dollar compensation payments worldwide.
• The confidence in the surface replacement was massively shaken.

Other systems, such as the BHR prosthesis, also lost acceptance. National registries, e.g., in the UK and Australia, published alarming revision rates.

3.6 Withdrawal from routine

After these experiences, many clinics decided to no longer offer surface replacement as a routine procedure. Specialist societies such as the German Society for Orthopaedics and Trauma Surgery (DGOU) and international institutions warned against metal-on-metal systems.

Today it applies:

• The surface replacement with metal-on-metal is only used in exceptional cases.
• Most orthopedic centers have completely abandoned it.
• Patients who still have a metal cap prosthesis in their body are regularly monitored (including blood values for metal ions).

3.7 Lessons from the past

The history of surface replacement shows how great the discrepancy between theory and practice can be.

Theoretically:

• Bone preservation, natural anatomy, high mobility.

Practical:

• Metal wear, inflammation, loosening, systemic risks.

The most important lesson: An implant must not only be technically fascinating - it must also be safe in the long term.

This is exactly where the current discussion is focused: If the problem was the material, could hip resurfacing with a new material – ceramic – be a real alternative?

3.8 Conclusion on the historical section

The surface replacement on the hip has a turbulent history:

• 1970s: first, not very successful attempts.
• 1990s/2000s: Boom due to metal-on-metal systems.
• From 2010: massive problems due to metal wear, recall actions, loss of confidence.
• Today: only rare indications, but exciting discussions about new materials.

Patients should be aware that the enthusiasm for surface replacement has always been based on the idea of preserving bone - a goal that remains highly relevant today. However, experience with metal-on-metal has shown how dangerous the wrong material choice can be.

4. The Innovation: Ceramic Resurfacing – the Comeback of the Cap Prosthesis?

4.1 Why ceramic?

After the problems with metal-on-metal prostheses, research focused for a long time on safe, biocompatible materials. Ceramic has proven to be extremely abrasion-resistant and biocompatible in endoprosthetics, particularly in acetabular cups and classical hip prostheses.

The benefits of ceramic at a glance:

• Biocompatibility: Ceramic does not react with the body, no systemic stress from metal ions.
• Abrieb immunity: Significantly less particle formation in the joint. The risk of metallosis is eliminated.
• Hardness: Ceramic is extremely hard and wear-resistant, making long-term durability theoretically possible.
• Smooth sliding surfaces: Reduce the risk of joint noises or micro-movements that could lead to loosening.

For patients, this means: The cap prosthesis can theoretically utilize the benefits of bone preservation without the risks of metal abrasion.

4.2 Structure and Functionality of the Ceramic Resurfacing Prosthesis

The ceramic cap prosthesis consists of several components:

Ceramic cap for the femoral head:

• Covers the preserved bone.
• Is cemented or press-fit fixed.

Acetabulum:

• Classic TEP socket made of ceramic or ceramic/polyethylene combination.
• Receives the cap and enables movement.

Fixation mechanism:

• Securing through bone compression or cement.
• Goal: immediate stability, no loosening.

In principle, the ceramic cap replaces the articular cartilage, while the natural bone remains preserved. The mobility of the joint can move very close to the original anatomy, and the load on the femoral neck remains physiological.

4.3 Potential benefits for patients

1. Bone-sparing:
   Especially for younger patients or people with higher activity, preserving the femoral neck is a significant advantage. If a revision is necessary at some point, more options are available.
2. No metal ions:
   Unlike metal-on-metal systems, the body is not exposed to metal ions – a significant safety improvement.
3. Low wear:
   Ceramic generates less surface wear, which could reduce the loosening rate in the long term.
4. Large head size possible:
   As with metal resurfacing prostheses, the femoral head can be chosen large, resulting in a lower dislocation rate.

4.4 Challenges and risks

Despite the theoretical advantages, there are significant limitations:

Ceramic fracture:
Ceramic is hard and wear-resistant, but also brittle. A fracture can have catastrophic consequences:

• Sudden instability of the joint
• Need for a complex revision surgery
• Potentially irreversible damage to the femoral head

Technical complexity of the operation:
To precisely place the cap on the femoral head, the joint must be dislocated. This means:

• Larger surgical approaches
• More soft tissue damage
• Longer rehabilitation time compared to minimally invasive short stem systems

Lack of long-term results:
While metal resurfacing prostheses have data over 10-15 years, there are only pilot studies or small cohorts available for ceramic resurfacing prostheses so far.

• Long-term stability is still unclear
• Revisions on a larger scale are not sufficiently documented

Limited availability:
Ceramic cap prostheses are currently only offered in specialized centers and not as a standard routine procedure.

4.5 Current clinical studies and research

In recent years, several research teams worldwide have launched pilot projects:

• Goal: Check load-bearing capacity, abrasion, dislocation risk and fracture resistance.
• First results:
• Low wear rate confirmed
• Dislocation rate low when implanted precisely
• Ceramic fractures very rare, but possible risk factors identified (e.g. mispositioning, suboptimal bone density)

Conclusion of the study authors: Ceramic is promising, but not yet widely clinically tested. Long-term data (10–15 years) are missing.

4.6 Patient Perspective: Opportunities vs. Risks

For patients, the ceramic cap prosthesis initially sounds like the ideal solution:

• Bone remains preserved
• No metal wear
• Physiological mobility

But the reality is complex:

• Surgery not minimally invasive possible
• Risk of ceramic fracture remains
• Long-term data are missing → uncertainty about durability and complications

Patients must weigh: Prefer an innovative but little-tested technique or a proven, safe alternative like the short-stem prosthesis, which can be used minimally invasively and is demonstrably durable.

4.7 Conclusion Chapter 4

The ceramic cap prosthesis represents the logical further development of surface replacement: bone preservation without metal risk.

But:

• Minimally invasive implantation is hardly possible
• Ceramic fracture remains a theoretical but real risk
• Long-term results are missing

Patients should be aware of these risks and always make decisions in consultation with experienced hip specialists .

5. Minimally invasive hip surgery – the revolution of the last 10 years

Hip surgery has made enormous progress in recent decades. In addition to material innovation, the focus is on minimally invasive surgical techniques . For patients, this means shorter hospital stays, less pain, faster mobilization, and less scarring.

5.1 What does "minimally invasive" mean?

The term "minimally invasive" describes surgical procedures that destroy as little tissue as possible and still allow for safe implantation.

Features of minimally invasive hip surgeries:

• Small incisions (approx. 6–10 cm vs. 15–25 cm with traditional approaches)
• Muscle-sparing technique: Tendons, muscles, and ligaments are not cut, but pushed aside
• Preservation of the joint capsule, if possible
• Goal: faster recovery, less pain, shorter rehabilitation

These techniques are now at the center of modern hip surgery and have revolutionized patient care.

5.2 The established minimally invasive approaches

In the last 10 years, the following approaches have become established:

1. AMIS (Anterior Minimally Invasive Surgery / Direct Anterior Approach):

• Anterior approach, between muscles
• No cutting of important muscle groups
• Very low dislocation rate
• Rapid mobilization possible

1. Anterolateral approach (ALMIS):

• Muscle-sparing access from the front side
• Stable joint guidance, low risk of dislocation
• Proven for short-stem and standard prostheses

1. Posterolateral approach (PL):

• Posterior approach, slightly modified to preserve muscles
• Classic approach, can be adapted minimally invasively

5.3 Benefits for patients

Minimally invasive hip surgeries offer measurable benefits:

Less blood loss:

• Gentler muscle preparation → fewer intraoperative bleeding
• Less frequent transfusions necessary

Less postoperative pain:

• Muscles and tendons remain largely intact
• Reduced need for pain medication

Rapid mobilization:

• Patients often get up on the day of surgery or the first day after surgery
• Shortened hospital stays (2–5 days instead of 7–10)

Cosmetically advantageous:

• Small incisions → smaller scars
• Aesthetically pleasing, especially for younger patients

Better functional results:

• Muscle strength restored more quickly
• Daily life and sports possible more quickly

These benefits are clinically proven and make minimally invasive approaches a standard in modern orthopedic centers today.

5.4 Evidence and study situation

Numerous studies confirm the benefits of minimally invasive hip replacement implantations:

• Shorter hospital stays (reduction by 2–4 days)
• Lower pain score in the first weeks after surgery
• Faster return to normal activities
• Equivalent long-term results regarding implant loosening compared to traditional approaches

Conclusion: Minimally invasive procedures have no influence on long-term stability, but significantly improve postoperative quality of life .

5.5 Why hip resurfacing cannot really be implanted minimally invasively

Here lies the crucial difference:

• In surface replacement, the hip head must be dislocated to precisely fit the cap.
• This requires a larger access and more soft tissue mobilization.
• Muscles and capsule are more heavily stressed → no minimally invasive approach possible.

Patient perspective:

• Despite modern material choices (ceramic), patients do not benefit from the minimally invasive advantages: higher pain, longer rehabilitation, larger scars.
• Minimally invasive is a key feature of modern hip surgery, which is technically challenging with hip resurfacing.

5.6 Summary Chapter 5

• Minimally invasive approaches are now standard in modern hip surgery.
• They enable faster recovery, less pain, and better functional results.
• The ceramic cap prosthesis cannot use these approaches, as luxation of the femoral head is necessary.
• This is one of the biggest disadvantages of surface replacement compared to modern short-stem prostheses, which can be implanted minimally invasively.

6. Risks of the ceramic cap prosthesis

At first glance, the ceramic cap prosthesis seems like the ideal solution: bone preservation, biocompatible material, less abrasion. However, reality shows that even this modern variant is associated with significant risks and uncertainties . Patients should be aware of these risks to make an informed decision.

6.1 Ceramic fracture – a rare but catastrophic risk

Ceramic is extremely hard and wear-resistant, but has a brittle structure

• Under high stress, incorrect positioning, or bone defects, the cap can break suddenly.
• A fracture leads to immediate instability of the joint.
• Affected patients require a complex revision surgery, often more complex than with classic short-stem prostheses.

Fact: Even if the probability of a fracture is low, the consequences are severe. Even small cracks can lead to loosening or pain.

6.2 Soft tissue damage due to necessary luxation

To place the ceramic cap on the femoral head, the joint must be dislocated .

• Muscles, tendons, and capsule are stretched or mobilized more strongly.
• Minimally invasive approaches are not possible, as sufficient space is needed for the cap.
• Result: more postoperative pain, longer rehabilitation, higher risk of postoperative muscle weakness.

Patients must understand: The surgery itself is more invasive than a modern short-stem implantation, although the material is actually innovative.

6.3 Lack of long-term results

While metal cap prostheses have 10-15 years of experience and registry data, there are only pilot studies or small cohorts for ceramic cap prostheses:

• Long-term stability over 15–20 years is unclear
• Revisions in the long-term course are hardly documented
• Data on physically active patients are missing

This means that the use remains experimental, even if initial results are promising.

6.4 Patient perspective

For young, active patients, the cap prosthesis sounds ideal:

• Bone remains preserved
• No metal wear
• Physiological joint mechanics

However, disadvantages such as non-minimally invasive access, ceramic fracture and uncertain long-term results must be clearly communicated. Patients who value rapid mobilization, short rehabilitation and proven, safe solutions should consider alternative options.

Modern hip surgery offers proven solutions for this: for example, the short-stem prosthesis, which is bone-preserving and can be used minimally invasively.

6.5 Transition to modern alternatives

The short stem prosthesis combines the advantages of the cap prosthesis (bone preservation, high mobility) with the benefits of minimally invasive technique:

• Implantation via small, muscle-sparing approaches
• Proven long-term results
• Easier revision if needed

7. Short stem prosthesis as a modern alternative

The short-stem prosthesis has established itself in recent years as the preferred solution for many patients who require hip surgery, but place value on bone preservation and minimally invasive technique . It combines the advantages of surface replacement with the achievements of modern hip surgery – without the risks of ceramic cap prostheses.

7.1 Structure and Functionality

The short-stem prosthesis differs from classical hip prostheses by the shortened stem, which is inserted into the proximal part of the thigh:

Short prosthesis stem

• Anchored in the upper thigh bone
• Gentler on the bone, less material in the medullary cavity

Ball head and cup

• Standardized ceramic or polyethylene acetabular cup
• The ball head can be chosen large → low risk of dislocation

Fixation

• Press-fit or cemented, depending on bone quality
• Immediate stability guaranteed

Advantage over cap prosthesis:

• No risky ceramic cap fracture
• Minimally invasive implantation possible
• Long-term results proven

7.2 Minimally Invasive Implantation

The short-stem prosthesis can be implanted via modern approaches :

• AMIS (Direct Anterior Approach): Muscles are spared, patients often stand on the day of surgery
• Anterolateral approach: Stable approach, low dislocation rate
• Posterolateral access: Modified muscle-sparing, proven

Patients benefit from these techniques:

• Less pain
• Faster mobilization
• Shorter hospital stay
• Smaller scars

Thus the short-stem prosthesis combines the advantages of the cap prosthesis (bone preservation) with those of minimally invasive hip surgery – a potential advantage over ceramic cap prostheses.

7.3 Evidence and long-term results

Registry data and clinical studies prove:

• Durability: Short stem prostheses have long durability, revisions easily possible
• Stability: Low loosening rate, no increased dislocation rates
• Function: Muscle strength and mobility comparable or better than with classic hip prostheses
• Patient satisfaction: High, especially in active patients

Conclusion: The short stem prosthesis is not experimental, but proven and safe.

7.6 Short stem prosthesis vs. surface replacement

Brief comparison:

• Surface replacement (ceramic): High bone preservation, minimally invasive implantation impossible, risk of ceramic fracture, experimental
• Short stem prosthesis: Bone preservation good, minimally invasive implantation possible, proven technique, revision easier

Conclusion: The short-stem prosthesis is today for most patients the practical, safe, and evidence-based alternative to surface replacement.

For patients in the Mainz and Rhine-Main area, ENDOPROTHETICUM under Prof. Dr. Karl Philipp Kutzner offers modern hip surgery with short-stem prostheses:

• Specialized in minimally invasive techniques
• Individual consultation and surgical planning
• High technical expertise, modern surgical technique, excellent aftercare

7.8 Conclusion Chapter 7

• The short-stem prosthesis combines bone preservation and minimally invasive implantation.
• Long-term results are proven, revisions are easier than with cap prostheses.
• Patients benefit from faster mobilization, less soft tissue damage and high security.
• For many young and active patients, it is the best choice when a hip prosthesis is necessary.

8. Surface replacement vs. short stem prosthesis – a direct comparison

The decision between surface replacement (especially ceramic capping prosthesis) and short stem prosthesis is often not easy for patients. Both procedures aim at bone preservation and functional hip movement , but differ significantly in safety, surgical access and long-term results.

8.1 Bone preservation

Surface replacement:

• Goal: maximum preservation of the femoral head
• Advantage in future revision surgeries
• Risk: In case of complications or ceramic fracture, less intact bone remains

Short stem prosthesis:

• Bone preservation moderate to high, as only the proximal femoral portion is processed
• More options remain available for revisions
• Advantage: Combination of safety and bone preservation

Conclusion: Surface replacement theoretically maximal, short stem prosthesis practical and safe.

8.2 Minimally invasive approaches

Surface replacement:

• Necessary luxation of the femoral head
• Greater soft tissue damage, potentially longer rehabilitation
• Minimally invasive implantation not possible

Short stem prosthesis:

• Implantation possible via muscle-sparing approaches (AMIS, ALMIS)
• Less soft tissue damage
• Rapid Mobilization

Conclusion: Minimally invasive advantages only achievable with short stem prostheses.

8.3 Material and safety

Ceramic surface replacement:

• Advantage: no metal abrasion, biocompatible
• Risk: Ceramic fracture with catastrophic consequences
• Long-term data missing

Short stem prosthesis (ceramic or polyethylene):

• Proven materials, low abrasion rate
• No brittleness, low risk of fracture or loosening
• Long-term data prove safety

Conclusion: Short-stem prostheses offer proven safety, surface replacement remains experimental.

8.4 Functional results

Surface replacement:

• Mobility close to the natural hip
• Risk of pain or limited function in case of complications

Short stem prosthesis:

• Mobility very good, comparable to surface replacement
• Muscles and tendons remain intact → faster daily life and sports

Conclusion: Functionally equivalent or better with short-stem prostheses thanks to minimally invasive technique.

Patient conclusion:
The short-stem prosthesis combines safety, bone preservation, and minimally invasive access. Surface replacement sounds theoretically attractive but is in practice riskier and hardly minimally invasive.

• Ceramic surface replacement is an exciting but experimental procedure.
• Minimally invasive advantages are not feasible, ceramic fracture remains a residual risk, long-term results are lacking.
• Short-stem prostheses offer proven safety, minimally invasive implantation and bone preservation.
• For patients who seek rapid mobility, short rehabilitation, and long-term safety , the short-stem prosthesis is the more practical choice.

9. Summary

The decision for a hip prosthesis is an important step for patients of any age. Modern procedures offer bone preservation, rapid mobilization, and safe long-term results, but not every procedure is equally suitable for every person. This article has extensively examined the differences between ceramic surface replacement and the short-stem prosthesis .

9.1 Key points at a glance

Ceramic surface replacement (capping prosthesis):

• Goal: maximum bone preservation and physiological joint movement
• Advantages: no metal wear, theoretically great mobility, bone-sparing
• Disadvantages:
• Dislocation of the femoral head necessary → no truly minimally invasive access
• Risk of ceramic fracture with serious consequences
• Long-term data missing, revisions complex
• Conclusion: Innovative, but experimental and with significant risks

Short stem prosthesis:

• Goal: Bone preservation combined with minimally invasive implantation
• Benefits:
• Minimally invasive possible via AMIS, anterolateral or posterolateral approach
• Proven materials (ceramic, polyethylene)
• Longer durability and safe long-term results (15–20 years)
• Easier revisions when needed
• Faster rehabilitation and lower postoperative pain
• Conclusion: Proven, safe and patient-friendly solution

9.2 Why minimally invasive is crucial

The last 10 years have shown that minimally invasive approaches are crucial for the success of hip surgery:

• Less soft tissue damage → less pain
• Faster mobilization → shorter hospital stays
• Better functional results → everyday life and sports possible faster

Patients who value quick recovery, minimal pain, and functional safety benefit particularly from minimally invasive techniques – which, unfortunately, are not feasible with resurfacing.

9.3 Bone preservation vs. safety

Resurfacing sounds attractive because it promises maximum bone preservation . But practice shows:

• Risks such as ceramic fracture or lack of long-term experience relativize the advantage
• Minimally invasive implantation is not possible → longer rehabilitation, more pain

The short-stem prosthesis, on the other hand, offers a balanced solution:

• Bone preservation is good to high
• Minimally invasive implantation
• Long-term results proven
• Revisions simpler and safer

For most patients, the short-stem prosthesis is therefore the more practical and safer choice.

9.4 Decision-making aid for patients

If you are planning hip surgery, you should consider the following points:

Age and activity level:

• Young, active patients particularly benefit from bone-sparing and minimally invasive methods.

Material selection:

• Ceramic offers advantages, metal carries abrasion risks, ceramic cap prostheses are still experimental.

Surgical approach:

• Minimally invasive techniques reduce pain, scarring and rehabilitation time.

Long-term results and safety:

• Proven systems (short-stem prosthesis) are long-term tested and revision-friendly.

Individual consultation:

• Each case is unique – detailed consultation with an experienced hip specialist is crucial.

If you are considering hip surgery or want to learn more about resurfacing arthroplasty, ceramic cap prostheses or short stem prostheses , the ENDOPROTHETICUM Rhein-Main under Prof. Dr. Karl Philipp Kutzner offers excellent expertise:

• Modern hip surgery with minimally invasive approaches
• Individual consultation to choose the optimal prosthesis
• Long-term proven short-stem prostheses, which combine bone preservation and fast recovery
• Professional aftercare and rehabilitation

• Ceramic resurfacing is innovative but experimental and associated with significant risks.
• Minimally invasive approaches are not possible for surface replacement prostheses.
• The short-stem prosthesis offers the perfect balance of safety, bone preservation, and minimally invasive implantation.
• Patients benefit from faster mobilization, safe long-term results, and revision-friendly technology.
• Individual consultation, such as at ENDOPROTHETICUM Rhein-Main , is the key to an optimal decision.