Improvements in materials and fixation have addressed many of the limitations of resurfacing total hip arthroplasty (THA). The functional demands and the longevity of arthroplasty patients are increasing. Many patients have embraced the functional capacity, bone conservation, and revision options of hip resurfacing. Young men have historically been at increased risk for failure of total THA. In this patient subgroup, the survivorship of hybrid metal-metal resurfacing THA has been demonstrated to exceed that of THA, but patient selection is critical. The procedure is now also conservative on the acetabular side, and revision of the cementless acetabular component is rare. The operative parameters of femoral resurfacing revisions (conversion to a THA) are similar to that of a primary THA. Bearing technology will continue to evolve.

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