A quick overview of my years of 'research':
Surgeon:
Pick the best, most experienced surgeon that you can find and afford. The operation is more difficult than a total hip due to the required alignment of the cap to make sure that it doesn't notch the bone and the placement of the acetabular cup. In a THR (total hip replacement), the top fo the femur is cut off giving a clear shot to the acetabular work. In resurfacing, the bone has to be tucked out of the way.
Dr Su in NY, Dr Gross in South Carolina, DeSmet in Belgium, Vijay Bose in India, McMinn in England are all big names. I mention the guy in India for those that may have insurance issues. Don't let the location scare you, he is the real deal.
Surgery technique:
Most do posterior approach. Minimal invasive is something that I was not concerned about. Cut it open wide enough to see whats going on. That being said, my doc (Gross) does 'minimal' and I have a 4" scar. The anterior approach seems to be preferred by those with more total hip experience. It may make for a shorter recovery, but there is a thought that it has a higher chance of nerve damage resulting in permanent leg drop. It also has fewer post op recovery movement restrictions that are more of an issue with small ball total hips.
Journal paper written by my doc...
Minimally Invasive Posterior Approach for Hip Resurfacing Ar... : Techniques in Orthopaedics
Device:
Big discussion here. the Smith and Nephew (BHR) claims the longest history. Early 90's with the current version being about 14 years old. Good track record when installed by good surgeons.
The Wright C+ also has a long track record with good results. The Wright is heat treated and claimed to be harder with better wear properties than the BHR.
Read this for a comparison...
http://www.surfacehippy.info/pdf/bhvsrconserv.pdf
(FYI, the surfachippy site is not tied to a manufacture that I know of and i've been following this stuff for years. The person that started the site got a resurfacing years ago and has been preaching about it to 'get the word out' and sell ad space.)
Heat treating is an interesting issue. It makes the metal harder for better wear, but then it is harder to machine to tolerance. That may have been one of the issues with the ASR device that was recently recalled due to higher failure rates.
Biomet:
I have the Biomet un-cemented device. Note, this is not yet FDA approved (perfectly OK to use in an 'off label' application), but has a solid track record in the hands of a good surgeon. I researched and felt that cement may be a long term weak link.
What is the Best Bone Fixation Type? by Dr. Gross
Prior devices (BHR, C+) cement the cap on the hip. Historically, cement has been a longer term failure point for total hips, but that cement is in shear. The porous surface was difficult to apply on the inside of the cap. Biomet has had one out for 4 years with great success.
Disclaimer: Dr Gross is the developing surgeon for the Biomet device. This initially freaked me out due to the potential conflict of interest, but talking with him and his team at great length and following his work and papers for years put my mind at ease. He has done thousands of installs (1300+ of the cementless resurface). I talked to several ortho doctors that had the procedure and Dr Gross was the guy they went to... for me it was the right fit.
Note: Apparently, the C+ device now also has a cement-less version that I've heard DeSmet is using. Not sure if its available in the US. My guess is that other manufacturers will go to the cement-less version, but that the BHR will stay cemented so they can provide a device with a long track record.
Activity with the resurfacing:
Most docs will not limit your activity after 6 months to 1 year. You can run, jump, etc. Google 'cory foulk resurface'... he's done several ironmen and ultra length tri's with his resurfaced hip. I suspect that more running and would increase the wear rate, butI dont know how much. Would it cut the life from 30 to 20 years? 100 to 80? Metal on metal was a viable choice for me. An article arguing the point...
http://www.grossortho.com/forms/Metal-metal%20Rationale-2-16-2011.pdf
Lots to digest and I only touched the surface. #1 priority is to get a great surgeon.
Also, the pain prior to surgery is such a freaking drain on life. It sucks. Its amazing for me to be able to sit in a car without pain, go for a walk, etc. I played 18 holes of golf on Saturday 4 months post op. No pain. I can easily put 40 miles on the bike now. No pain. The weight that's been lifted is amazing. I hope it lasts a long time. I think it will, but there are no guarantees in life.
Good luck, ask questions if you have them.
-bernie