I outlined some recent perspectives about hip resurfacing in a post almost two years ago. These perspectives are still well supported as the findings by McLawhorn et al. show. They performed a propensity-score matched analysis between THA and hip resurfacing in “appropriate” patients. They conclude:
HRA may provide a functional benefit in sports and recreation and greater satisfaction in patients who meet the current criteria for HRA. Because these benefits may be small, pre-operative counseling should focus on balancing the possible functional benefits against the longer-term risks associated with metal-on-metal bearings.
This conclusion is very much the same Giori wrote few years back:
For me, patients who truly fit the inclusion criteria are extremely rare, the possible benefits to these patients of SRA compared with total hip arthroplasty are slight (if at all present), and the possible risks of the metal-on-metal articulation remain a concern
Patients suitable for hip resurfacing do great with traditional stemmed THA. I think differences observed between the groups in the study by McLawhorn might be explained by residual confounding. To date, no robust evidence support the proposed theoretical advances of hip resurfacing.