The five-year results of the Birmingham Hip Resurfacing arthroplasty

Abstract

Few independent studies have reported the outcome of resurfacing arthroplasty of the hip. The aim of this study was to report the five-year clinical outcome and seven-year survival of an independent series. A total of 610 Birmingham Hip Resurfacing arthroplasties were performed in 532 patients with a mean age of 51.8 years (16.5 to 81.6). They were followed for between two and eight years; 107 patients (120 hips) had been followed up for more than five years. Two patients were lost to follow-up. At a minimum of five years' follow-up, 79 of 85 hips (93%) had an excellent or good outcome according to the Harris hip score. The mean Oxford hip score was 16.1 points (sd 7.7) and the mean University of California Los Angeles activity score was 6.6 points (sd 1.9). There were no patients with definite radiological evidence of loosening or of narrowing of the femoral neck exceeding 10% of its width. There were 23 revisions (3.8%), giving an overall survival of 95% (95% confidence interval 85.3 to 99.2) at seven years. Fractured neck of femur in 12 hips was the most common indication for revision, followed by aseptic loosening in four. In three hips (three patients) (0.5%), failure was possibly related to metal debris. Considering that these patients are young and active these results are good, and support the use of resurfacing. Further study is needed to address the early failures, particularly those related to fracture and metal debris.

Metal-on-metal hip resurfacing arthroplasty: A review of periprosthetic biological reactions

“…They have the potential to substantially reduce long-term wear-induced osteolysis as the major cause of failure. Short-term clinical follow-up reports on MoM hip resurfacing have been encouraging (Sieber et al 1999, MacDonald et al 2003, Treacy et al 2005, Hing et al 2007, Steffen et al 2008 with extremely low rates of failure reported in spite of the fact that patients have resumed high-level occupational and leisure activities. Medium-to long-term outcome is, however, unknown.…”

Activity intensity, assistive devices and joint replacement influence predicted remodelling in the proximal femur

“…Considering the BHR implant, which has performed well clinically since its introduction in 1997, characteristic adaptations include narrowing of the femoral neck, medial trabecular densification and formation of pedestal lines around the metaphyseal stem (McMinn et al 1996;Pollard et al 2006;Hing et al 2007;Steffen et al 2008). Further changes observed after retrieval include resorption inside the femoral head.…”

Should We Worry About Periacetabular Interference Gaps in Hip Resurfacing?

“…Likewise, porous-coated press-fit acetabula have demonstrated similar survivorship at a mean followup of 5 to 10 years with their use in hip resurfacing arthroplasty [2,7,9,19,23]. However, underreaming the acetabulum for fixation of an oversized press-fit component has been associated with acetabular fractures [3,10] and incomplete component seating [2,6,12].…”