When Dr. Gross came to see me the day after my surgery, I took the opportunity to ask him about the trochanteric flip (osteotomy) approach to resurfacing. I have been curious about this since Carla (T. Flippy Hippy) started posting, and I think others on this site may be interested also. I actually took some notes afterwards so I would not forget what he said, because I was still on narcotics. I think my notes are pretty accurate.
Dr. Gross said this procedure was developed by Dr. Ganz in Switzerland for performing hip impingement surgery. Some doctors then started using it for resurfacing. They theory was that younger people have less blood supply to the femoral head, and therefore, this approach would work better for younger people. However, Dr. Gross, who has performed many, many resurfacing operations on younger people, said he has not found this to be true.
Most of the doctors who used this approach for resurfacing have now stopped because of complications due to problems with the osteotomy not healing (4-5%), and if it does not heal properly, the patient becomes a cripple. The rate of femoral head problems with the posterior approach is less then 1%. Dr. Gross said he did perform one surgery using this approach and concluded that any possible advantages did not justify the risk.