I use a very wide variety of head sizes in my practice. There a few main issues to consider here: 1) larger head sizes can increase stability with certain approaches, 2) certain head sizes work better with certain bearing surfaces in terms of long-term wear & 3) head sizes may be limited to size of your natural “cup” (acetabulum of pelvis). In general, head sizes larger than 40mm seem to have the best wear in terms of metal-on-metal, whereas 36mm heads seem to work well with our current polyethylene. Current designs accomodate sizes from 28mm-62mm or larger, depending on patient size & the size of the appropriate implants.
The SuperPATH hip approach that I use recieves it’s stability from natural muscle preservation. It does not need implant size to help in that regard. My selection of head size is based almost entirely on your anatomy & potential wear.