@ljpviper, I was definitely biased towards another resurfacing given my great experience with my first hip; however, the following convinced me to go with anterior THR:
1) My prior resurfacing was done by Amstutz/Smalzreid in Los Angeles, but they had seemingly shut down their practice and had some sort of diffculty with certain failed procedures and/or medical devices, not sure exactly. 20 years ago when they pioneered the resurfacing procedure, I was an early pre-FDA approved test case.
2) While many other hip surgeons had since taken up resurfacing, it had fallen out of favor the past 5+ years to a large degree as compared to advancements in anterior THR.
3) I was examined by at least 4 hip surgeons prior to choosing Dr. Dennis Chang. All recommended anterior despite my prior resurfacing success. All commented that I was lucky not to have any problems with resurfacing as the femoral neck (before the ball) is the least strong bone component of the femur and required both strong bone and a well executed ball mount installation due to tight tolerances. All suggested the anterior procedure avoided muscular cuts, larger incision, and the least amount of tissue stretching therefore allowing faster recovery, lesser dislocation exposure, and better surgery outcome with less bleeding.
4) Resurfacing is largely metal on metal and there is the risk of metal particulates over time and wear entering the bloodstream and causing weakness of bone/metal adhesion along with other health risks. This is the case for one resurfacing, but two would create much higher risk and potential concentration of metal particulates.
5) Most anterior THR surgeons suggested the latest technology would last 20+ years. That was not the case 20 years ago, and even resurfacing was hoped to last 10+ years back then if one was lucky. At 40 years old despite resurfacing being early days, I almost felt as if there was no choice back then given I would likely need at least one revision of the resurfacing and wanted to preserve as much bone as possible. At 60 and with expected longevity of anteior THR, I felt more comfortable with modern anterior THR.
6) My biggest mental block to anterior THR was the notion of a femoral stem inserted into the hollow femur struck me as something of a “log splitter” and I feared bone fracture at my activity and larger size. All the anterior surgeons stated my larger, stronger bone structure was ideal for anterior THR and that risk of fracture in my case was 1% or less.
Sorry for the long response, and some of it may be countered by those with more recent resurfacing success. Obviously, Andy Murray’s resurfacing success is remarkable and can certainly provide a great alternative especially to younger candidates.