Michael Puertas has been playing squash for three decades, racking up an impressive record. Then three years ago, pain in his right hip began to wake him up at night. He knew surgery was inevitable but he didn't want to give up squash.

"My consultation with the doctor was I won a national championship last year, and after this operation, I'd like to win another," he said.

Dr. Robert Barrack suggested an alternative to traditional hip replacement.

"With hip resurfacing you don't remove the femoral head. You leave the patient's own normal bone, and just put a metal surface over the cap of it, sort of like capping a tooth."

Dr. Barrack and his colleagues studied 800 patients age 60 or younger who had either hip replacement or hip resurfacing. One year after the operation, patients with resurfacing were less likely to limp, had less thigh pain, and were able to return to impact sports.

However, hip resurfacing is not for everyone. Replacement parts are not a good fit for smaller patients, or for women. The best candidates are under age 60, with a large frame and healthy bones.

Ten months after the surgery, Michael Puertas won the U.S. national 40-plus squash championship.

Hip resurfacing is not new, but the technique has vastly improved.