Osteoarthritis of the hip affects approximately 10% of people over the age of 60–65, but it can also occur in younger adults due to genetic predisposition, post-traumatic conditions, or rheumatic diseases. Until now, surgical treatment has primarily involved total hip replacement using modern, minimally invasive or robotic-assisted implantation techniques.
A Groundbreaking Alternative: Hip Resurfacing with Anterior Approach (HRAA)
In June 2026, a pioneering new technique—Hip Resurfacing Anterior Approach (HRAA) using advanced ceramic-on-ceramic implants—was performed for the first time in Greece. The procedure was carried out by orthopedic surgeon Dr. Athanasios Koukakis, Director of the 7th Orthopedic Clinic – Robotic and Minimally Invasive Surgery Unit at Metropolitan General Hospital. A series of patients aged 40 to 65 with advanced hip osteoarthritis successfully underwent the surgery.
Unlike traditional total hip replacement—which removes the femoral head—HRAA preserves it. Instead, the natural femoral head is resurfaced with a state-of-the-art ceramic cap that articulates with a matching ceramic acetabular implant. This bone-preserving approach maintains structural integrity and leaves more native bone available for potential future revision surgeries—a critical advantage for younger patients.
Who Is This Procedure For?
HRAA is intended for active men and women under the age of 65—including those engaged in sports or physically demanding lifestyles. It is not recommended for patients with advanced osteoporosis or severe hip dysplasia.
Key Advantages
The technique offers several clinical benefits: significantly faster recovery, with hospital stays typically lasting just one to two days; early mobilization supported by fast-track rehabilitation protocols; near-physiological hip motion and function; and a lower risk of dislocation compared to conventional total hip replacement. Its anterior surgical approach further enhances precision and tissue preservation.
Considerations and Limitations
Challenges include the higher cost of ceramic implants and the need for specialized surgical expertise due to increased technical complexity. While ceramic-on-ceramic hip resurfacing has been used successfully for seven years in leading centers across the UK and Belgium—replacing earlier metal-on-metal versions—Greece is now among the first European countries to adopt the HRAA method.