Conservative hip arthroplasty with resurfacing of the acetabulum and the femoral head is an attractive concept particularly in young and active patients. The principal advantages are less femoral bone destruction and resection, avoidance of stress shielding in the proximal femoral shaft; however this technique don’t permit a same preservation of acetabular bone stock and a mini invasive surgical approach.

From January 2003 the Authors have performed 5 metal-on-metal Birmingham hip resurfacings in patient under the age of 58 with avascular necrosis of the femoral head (without a wide necrosis) or primary osteoarthritis. In all cases was performed a posterior approach slightly more extended to permit the release of the gluteus maximus tendon; the rehabilitation program involve immediate full weight bearing one day postoperatively. Data were collected intraoperatively and postoperatively in a prospective way.

The early clinical and radiological results are very satisfactory: resurfacing hip arthroplasty appears to be a good alternative for the treatment of young patients, permitting a preservation of femoral bone stock and early functional recovery. In our opinion the key factors for a good result is a meticulous technique and a good bone quality.