There are pros and cons. The advantages include:

1. Less bone is removed
2. It is more durable than standard total hip replacement in young people (96% survivorship at 8 years in the English literature) ,
3. Stability is better: a. no dislocation b. Minimal early postoperative hip precautions c. No hip precautions after 6 months
4. No thigh pain ,
5. Less risk of blood clots (3 in 700 in my experience , compared to 10% with total hip replacement) ,
6. Less blood loss in surgery (transfusion is required in less than 1% in patients with a preoperative hemoglobin greater than 13; there is no need for autologous blood collection).

Recently large bearing metal-metal total hip replacements have become available as well (Biomet Magnum , released 12/2004 in the US market). We expect them to be just as durable and stable as hip surface replacement. The disadvantages of hip surface replacement include: % 1. 1% femoral neck fracture.% 2. 2% femoral head avascular necrosis. Both of these complications require revision of the femoral side to a large bearing implant that will mate with the acetabular component in place.