The potential disadvantages of hip resurfacing are femoral neck fractures (rate of 0–4%), aseptic loosening, and metal wear. Due to the retention of the person's complete femoral neck other advantages exist: Surgeon induced discrepancies in leg length (as could happen with THR) are now minimized. Also, the toe-in or toe-out faults that could occur interoperatively with THR are now over because the femoral neck that determines foot direction is left undisturbed with hip resurfacing.
The potential advantages of hip resurfacing compared to THR include less bone removal (bone preservation), a reduced chance of hip dislocation due to a relatively larger femoral head size (given that the person has an anatomically correct femoral head size), and easier revision surgery for any subsequent revision to a THR device because a surgeon will have more original bone stock available. Hip resurfacing has the potential of being a solution for life, allows a normal ROM (range of movement) and minimizes the amount of "stress shielding", compared with THR. Since the femoral neck is retained and the femoral cavity with its marrow not opened up two other advantages exist, namely no risk of blood clots by fatty marrow that can enter the blood stream with the THR procedure and no risk of introducing bacteria in the opened femoral canal resulting in a deep infection as can happen with the THR procedure.