The Influence of Surgical Approach on Outcome in Birmingham Hip Resurfacing

McBryde, Callum; Revell, Matthew P.; Thomas, Andrew; Treacy, R. B. C.; Pynsent, Paul

doi:10.1007/s11999-008-0121-y

Cited by 48 publications

(36 citation statements)

References 22 publications

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“…The clinical results in terms of ROM, hip scores, and activity levels compared well with those reported by others [15,16,24,31,32,38,39]. Radiographically, sclerotic changes around the short femoral stem (pedestal sign) were detected in 40% of the hips, which is less than the 60% reported by Pollard et al [32].…”

Section: Discussionsupporting

confidence: 82%

“…Unfortunately, we cannot draw valid conclusions in comparison with other HRA implants as our series focused only on the Durom prosthesis. However, better outcomes in terms of failure or revision have been reported for the BHR; 4-to 7-year survival rates varied between 94% and 100% [15,16,24,31,32,38,39]. The data from the Australian Joint Registry also suggested that the BHR has the lowest 5-year revision rate of all devices compared [33].…”

Section: Discussionmentioning

confidence: 99%

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High Revision Rate at 5 Years after Hip Resurfacing with the Durom Implant

Naal

Pilz

Munzinger

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background/rationale There is growing evidence that different resurfacing implants are associated with variable survival and revision rates. A registry analysis indicated the Durom resurfacing implant had high revision rates at 5 years, whereas three original studies reported low revision rates at short-term followups. Thus, the revision rates appear controversial. Questions/purposes We therefore assessed (1) the survivorship including differences between women and men at a mean of 5 years after resurfacing with the Durom implant, and (2) clinical scores and radiographic parameters. Patients and Methods We prospectively followed all 100 Durom hip resurfacings implanted in 91 patients (25 women and 66 men; mean age, 52 years) between 2003 and 2004. Survivorship analysis was performed with pending revision or revision for any reason as the endpoint. The minimum followup was 47 months (mean, 60 months; range, 47-72 months).Results At a mean of 5 years, 11 hips were revised for various reasons. Cumulative survival was 88.2% for all patients and 81.5% for women. The mean Oxford (OHS) and Harris hip (HHS) scores were 14.6 and 94.7, respectively. The mean UCLA activity level was 7.9. Sclerotic changes around the short femoral stem (pedestal sign) were detected in 40% of the hips. We observed considerable femoral neck thinning with component-to-neck ratios of 0.85 preoperatively and 0.82 at 5 years. Conclusions Our study highlights a high revision rate 5 years after hip resurfacing with the Durom implant. This observation underlines previous findings from registry data and suggests that revision rates increase with time.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

High Revision Rate at 5 Years after Hip Resurfacing with the Durom Implant

Naal

Pilz

Munzinger

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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“…However, it is unclear if the length of the incision improves the functional outcome. Surgical approach has not affected outcome of hip resurfacing [33]. Aggressive rehabilitation and not incision length apparently shortens recovery [48].…”

Section: Discussionmentioning

confidence: 99%

Factors Influencing Early Rehabilitation After THA: A Systematic Review

Sharma

Morgan

Cheng

2009

Clin Orthop Relat Res

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A wide variation exists in rehabilitation after total hip arthroplasty (THA) in part due to a paucity of evidence-based literature. We asked whether a minimally invasive surgical approach, a multimodal approach to pain control with revised anesthesia protocols, hip restrictions, or preoperative physiotherapy achieved a faster rehabilitation and improved immediate short-term outcome. We conducted a systematic review of 16 level I and II studies after a strategy-based search of English literature on OVID Medline, PubMed, CINAHL, Cochrane, and EMBASE databases. We defined the endpoint of assessment as independent ambulation and ability to perform activities of daily living. Literature supports the use of a multimodal pain control to improve patient compliance in accelerated rehabilitation. Multimodal pain control with revised anesthesia protocols and accelerated rehabilitation speeds recovery after minimally invasive THA compared to the standard approach THA, but a smaller incision length or minimally invasive approach does not demonstrably improve the short-term outcome. Available studies justify no hip restrictions following an anterolateral approach but none have examined the question for a posterior approach. Preoperative physiotherapy may facilitate faster postoperative functional recovery but multicenter and welldesigned prospective randomized studies with outcome measures are necessary to confirm its efficacy.

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“…Indeed, even if Myers et al [23] and McBryde et al [24] suggest that the surgical approach slightly modifies the position of the femoral implant and survival, it is vital for the surgeon to preserve the vascularity of the femoral head and neck [25].…”

Section: Discussionmentioning

confidence: 99%

Radiological validation of a fluoroscopic guided technique for femoral implant positioning during hip resurfacing

Chiron

Pailhé

Reina

et al. 2013

International Orthopaedics (SICOT)

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Purpose The positioning of the femoral cup in hip resurfacing is essential for the survival of the implant. We described a technique in 2005 to position the femoral cup guided by fluoroscopy independent of the approach performed. The main objectives were to study the positioning of the femoral components of the implant and the accuracy of the technique. Methods Between 2003 and 2011 we conducted a prospective study of 160 consecutive hip resurfacings all operated with this fluoroscopic-guided technique. Three independent observers performed a radiographic analysis at the pre-operative planning stage and on postoperative radiographs using OsiriX software. The statistical analysis was based on comparison of two groups by Student's t test. Results The entire implant was positioned in valgus, with an average of 7.816°valgus (p <0.001). All implants were positioned in neutral or anteverted with a mean of 1.98°( p <0.001). The risk of malpositioning on the antero-posterior plane was less than 1.41°with p <0.019. The risk of profile positioning error was lower than 0.80°with p <0.047. ConclusionThis study validates a technique of femoral implant positioning for resurfacing. It is simple, precise and independent of the approach performed.

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The Influence of Surgical Approach on Outcome in Birmingham Hip Resurfacing

Abstract: Level III, therapeutic study. See the Guidelines for authors for a complete description of levels of evidence.

Cited by 48 publications

References 22 publications

High Revision Rate at 5 Years after Hip Resurfacing with the Durom Implant

High Revision Rate at 5 Years after Hip Resurfacing with the Durom Implant

Factors Influencing Early Rehabilitation After THA: A Systematic Review

Radiological validation of a fluoroscopic guided technique for femoral implant positioning during hip resurfacing

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