10-year results of the Birmingham Hip Resurfacing: a non-designer case series

Hunter, Thomas J A; Moores, Thomas; Morley, David; Manoharan, Gopikanthan; Collier, Simon; Shaylor, Phillip

doi:10.5301/hipint.5000518

Cited by 12 publications

(16 citation statements)

References 24 publications

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“…The implant survival in female patients proved to be much worse, with the majority of revisions due to ARMD. Poorer implant survival in female MoM patients is also reported in other studies, 24,25 with recent literature indicating that females might be more hypersensitive to implant metals. 26 While recent research on MoM hip arthroplasty explores the pathogenesis of ARMD, 26,27 there is much debate on the optimal follow-up algorithm for the estimated one million patients who previously received a MoM hip articulation.…”

Section: Discussionsupporting

confidence: 72%

Limited need for screening of metal-on-metal hip resurfacing patients beyond 10 years of follow-up

et al. 2020

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Background: National and international guidelines lack consistency on how to screen metal-on-metal (MoM) hip arthroplasty patients for adverse reactions to metal debris (ARMD). Long-term outcomes of MoM hip arthroplasty are scarce, hindering further development of such guidelines. We present the clinical, radiological and ARMD status of 158 cases of hip resurfacing with >10 years follow-up. Methods: A prospective analysis of a cohort of 298 consecutive hip resurfacing procedures was performed at a single institution. All patients underwent MARS-MRI scanning for pseudotumour screening at least once, regardless of symptoms. Implant survival and reasons for revision were analysed for all patients. Clinical, radiological and MARS-MRI results were analysed for 158 unrevised procedures with >10 years follow-up. Results: The implant survival was 85.9% at 14.5 years (95% CI, 81.9–90.6) with revision for all causes as endpoint and 92.3% with MoM disease-related revisions excluded (95% CI, 88.2–95.0). Of the 158 cases with >10 years follow-up, 1 had elevated metal ion levels, 29 had a stable C1 pseudotumour and 6 a stable C2 pseudotumour. All pseudotumours were observed within 3 years after initiating our intensified ARMD screening (2011), with no new pseudotumours observed after that period. Conclusions: We suggest that follow-up of MoM hip resurfacing patients beyond 10 years after surgery can be done with large intervals (i.e. every 5 years), and only earlier if a patient becomes symptomatic.

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Section: Discussionsupporting

confidence: 72%

Limited need for screening of metal-on-metal hip resurfacing patients beyond 10 years of follow-up

et al. 2020

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“…The NJR lists the 15-year cumulative survivorship of MoM HRA at 85.16%. 13 Hunter et al 29 reported ten-year cumulative survivorship of 91% (males 97%; females 80%) in 121 hips (111 patients) with BHR. Daniel et al 8 showed 95.8% cumulative survival at 15 years (95% CI 95.1 to 96.5), again with males performing better with a 98% survival (95% CI 97.4 to 98.6).…”

Section: Discussionmentioning

confidence: 99%

Metal-on-metal hip resurfacing arthroplasty provides excellent long-term survivorship and function in patients with a good-sized femoral head

et al. 2022

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Aims To establish the survivorship, function, and metal ion levels in an unselected series of metal-on-metal hip resurfacing arthroplasties (HRAs) performed by a non-designer surgeon. Methods We reviewed 105 consecutive HRAs in 83 patients, performed by a single surgeon, at a mean follow-up of 14.9 years (9.3 to 19.1). The cohort included 45 male and 38 female patients, with a mean age of 49.5 years (SD 12.5) Results At the time of review 13 patients with 15 hips had died from causes unrelated to the hip operation, and 14 hips had undergone revision surgery, giving an overall survival rate of rate of 86.7% (95% confidence interval (CI) 84.2 to 89.1). The survival rate in men was 97.7% (95% CI 96.3 to 98.9) and in women was 73.4% (95% CI 70.6 to 75.1). The median head size of the failed group was 42 mm (interquartile range (IQR) 42 to 44), and in the surviving group was 50 mm (IQR 46 to 50). In all, 13 of the 14 revised hips had a femoral component measuring ≤ 46 mm. The mean blood levels of cobalt and chromium ions were 26.6 nmol/l (SD 24.5) and 30.6 nmol/l (SD 15.3), respectively. No metal ion levels exceeded the safe limit. The mean Oxford Hip Score was 41.5 (SD 8.9) and Harris Hip Score was 89.9 (14.8). In the surviving group, four patients had radiolucent lines around the stem of the femoral component, and one had lysis around the acetabular component; eight hips demonstrated heterotopic ossification. Conclusion Our results confirm the existing understanding that HRA provides good long-term survival and function in patients with adequate-sized femoral heads. This is evidenced by a 97.7% survival rate among men (larger heads) in our series at a mean follow-up of 14.9 years. Failure is closely related to head sizes ≤ 46 cm. Cite this article: Bone Jt Open 2022;3(1):68–76.

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“…Our findings corroborate the long-term efficacy of BHR in young male patients by demonstrating good implant survivorship (with 93.8% of male patients' BHR surviving past 13 years), improvements in patientreported outcomes, and sustained ability to participate in activities and sports beyond 10 years postoperatively. While many studies have reported long-term outcomes of the BHR, [12][13][14][15][16][17][18][19][20][21] most had heterogeneous cohorts of patients who underwent hip resurfacing for different underlying diagnoses. Our study represents a large single-surgeon case series assessing 10-year survivorship, functional and radiological outcomes in consecutive BHRs performed for osteoarthritis.…”

Section: Discussionmentioning

confidence: 99%

“…3 Other added benefits of hip resurfacing include the preservation of femoral bone stock, more accurate biomechanical restoration of the hip anatomy, decreased proximal femoral stress shielding, lower rates of dislocation, and superior patient-reported outcomes. [4][5][6] A number of studies have reported mid-term outcomes 5,[7][8][9][10][11] and long-term (minimum follow-up of 10 years) outcomes [12][13][14][15][16][17][18][19][20][21] of patients following BHR. However, most of those studies included patients with varying diagnoses, with no exclusions.…”

mentioning

confidence: 99%

Birmingham Hip Resurfacing for osteoarthritis — a Canadian retrospective cohort study with a minimum 10-year follow-up

Bourget-Murray

Kearns

Piroozfar

et al. 2022

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Background: Young men with osteoarthritis of the hip are a growing segment of the population requiring arthroplasty, and there is compelling evidence that the Birmingham Hip Resurfacing (BHR) system provides good functional outcomes and durability in young, active men. We reviewed the survivorship and clinical outcomes of patients who underwent BHR with a minimum follow-up of 10 years. Methods:We analyzed survivorship using the Kaplan-Meier method. Functional scoring was performed using the Harris Hip Score (HHS),

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10-year results of the Birmingham Hip Resurfacing: a non-designer case series

Abstract: Our results reflect that of the wider literature in that good outcomes can be obtained with this implant in a select group of patients and results are comparable to that of conventional hip arthroplasty in patients of a similar age.

Cited by 12 publications

References 24 publications

Limited need for screening of metal-on-metal hip resurfacing patients beyond 10 years of follow-up

Limited need for screening of metal-on-metal hip resurfacing patients beyond 10 years of follow-up

Metal-on-metal hip resurfacing arthroplasty provides excellent long-term survivorship and function in patients with a good-sized femoral head

Birmingham Hip Resurfacing for osteoarthritis — a Canadian retrospective cohort study with a minimum 10-year follow-up

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