Short-term Results of Birmingham Hip Resurfacing in the United States

Abstract

Previous data on the survivorship of the Birmingham Hip Resurfacing (BHR) implant have come from design surgeons and large national databases outside of the United States, and there is a lack of reported outcomes of surface replacement arthroplasty from US centers. A retrospective study was undertaken of 1271 hips treated with a BHR system (Smith & Nephew, Memphis, Tennessee) between June 2006 and September 2008 at 6 high-volume total joint centers in the United States. Demographic features, Harris Hip Score (HHS), and radiographic findings were recorded. Patients who did not have a 2-year follow-up visit were contacted by telephone. All patients were asked about complications, reoperations, or failure of the implants. Of the treated hips, 1144 (90%) had a minimum of 2 years of clinical follow-up (mean, 2.9 years; range, 1.8-4.2 years). Mean age was 52.3 years, and 75% of patients were men. Mean HHS improved from 55.8 preoperatively to 97.4 at the most recent follow-up (P<.001). There were 16 (1.4%) revisions to total hip arthroplasty (THA) for fracture (7), early dislocation (3), acetabular component malpositioning with pain (3; 1 with metallosis), infection (1), femoral loosening (1), and pseudotumor (1). There were 9 additional complications (0.8%) that did not require revision, including 3 dislocations treated with closed reduction, 2 fractures, 3 nerve injuries, and 1 pseudotumor. At 2 to 4 years of follow-up, the revision rate and the major complication rate with the BHR system were similar to those in previous reports of primary THA. Excellent clinical results were observed, but further follow-up is necessary to assess mid- and long-term results with the BHR system in US patients.

Periprosthetic Intertrochanteric Fracture between Hip Resurfacing and Retrograde Nail

“…Spontaneous femoral neck fractures after hip resurfacing are a recognized but uncommon complication. Short-term rates of fractures have been reported to occur between 0.5% and 1.3% [ 9 , 10 ]. A large, single-surgeon series demonstrated 2 femoral neck fractures in a group of 1333 (0.15%) patients at an average follow-up of 4 years [ 11 ].…”

A prospective comparative study of hip resurfacing arthroplasty and large-diameter head metal-on-metal total hip arthroplasty in younger patients—a minimum of five year follow-up

“…This is one of the limitations of this study. Numerous published literatures [5,9,16,22,25] reported excellent short-to mid-term outcomes in HRA. The significantly longer surgical time in HRA group can be explained by more complexity and higher technique demanding of this procedure.…”

Computer-assisted navigation in Birmingham hip resurfacing: A case report

“…3,17 However, incorrect positioning of components during BHR can lead to early complications and early BHR failure. 18,19 While inaccuracies in positioning related to the femoral component increase the risk of loosening and fracture, 20,21 acetabular component malposition is associated with accelerated wear, impingement, and early dislocation. 22 The utilization of computer-assisted navigation during resurfacing procedures has largely focused on the positioning of the femoral component.…”