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Does surgical approach influence component positioning with Birmingham Hip Resurfacing?
G J C Myers1, D Morgan, C W McBryde
1Worcester Royal Hospital, Charles Hastings Way, Worcester, WR5 1DD, UK. gjcmyers@aol.com
International Orthopaedics
|October 31, 2007
Summary
This study compared Birmingham Hip Resurfacing (BHR) component positioning using direct lateral versus posterolateral approaches. Both surgical methods yielded similar implant survival and patient outcomes, but the posterior approach resulted in a more closed acetabular component angle.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Total Hip Arthroplasty
Background:
- Hip resurfacing arthroplasty is an alternative to total hip replacement for osteoarthritis.
- Surgical approach selection can influence component positioning and patient outcomes.
- Birmingham Hip Resurfacing (BHR) is a specific type of hip resurfacing implant.
Purpose of the Study:
- To compare the component positioning of Birmingham Hip Resurfacings (BHR) implanted via direct lateral versus posterolateral surgical approaches.
- To evaluate implant survival, patient-reported outcomes (Oxford Hip Score), and complication rates between the two approaches.
Main Methods:
- A retrospective analysis of 64 Birmingham Hip Resurfacing (BHR) procedures performed by a single surgeon.
- Procedures were divided into two groups based on surgical approach: direct lateral (n=23) and posterolateral (n=41).
- Component positioning (acetabular abduction, stem orientation) was assessed, along with implant survival, Oxford Hip Scores, and complications.
Main Results:
- No significant differences were observed in implant survival, Oxford Hip Scores, or complication rates between the direct lateral and posterolateral approaches.
- The mean abduction angle of the acetabular component was significantly lower with the posterolateral approach (37.5°) compared to the direct lateral approach (43°).
- There were no significant differences in femoral stem orientation (flexion/extension, varus/valgus) between the two surgical approaches.
Conclusions:
- Both direct lateral and posterolateral approaches allow for acceptable component positioning in Birmingham Hip Resurfacing (BHR).
- The posterolateral approach is associated with a more medialized or 'closed' acetabular component angle compared to the direct lateral approach.
- Surgical approach does not appear to significantly impact implant survival, functional outcomes, or complication rates in BHR.
