The optimal metal-metal arthroplasty is still a total hip arthroplasty: in the affirmative.

Metal-metal hip resurfacing offers the advantage of conservation of femoral bone stock. In addition, the implant may offer enhanced resistance to dislocation in comparison with conventional total hip arthroplasty (THA). However, early and intermediate results of the procedure do not exceed those of conventional THA. The learning curve is steep for the procedure, and there are biomechanical and anatomic limitations to resurfacing that limit the applicability of the procedure. Although there will undoubtedly be a place for hip resurfacing in the armamentarium of the reconstructive hip resurfacing, it cannot be argued at this time that the optimal metal-metal hip arthroplasty is a hip resurfacing. Conventional metal-metal THA remains the "gold standard" at this time.