Second-decade survivorship may not be as predictable for total hip resurfacing as for THA. The operation requires more surgical exposure and is more difficult to perform reliably than a large-head metal-on-metal THA. Perhaps we have solved some of our prior dilemmas and created some new risks for the future with hip resurfacing arthroplasty, with many questions remaining unanswered. For now, we will stick with what works and solves real clinical problems for both the surgeon and the patient: the conventional THA with a large-head metal-on-metal articulation.