Birmingham Hip Resurfacing Using a Novel Mini-navigation System: A Case Report

Inaccurate positioning of acetabular and femoral components during Birmingham Hip Resurfacing (BHR) can lead to increased wear, edge-loading, and failure of the prosthesis, a consequence of substantial concern for young and active patients seeking long- term, post-operative survival of the joint. In turn, sizing of the acetabular component during BHR is limited by the size of the native femoral neck, and reaming of the acetabulum should be minimized to optimize the bony architecture for potential subsequent arthroplasties. Computer-assisted navigation systems (CAS) can improve the accuracy of component selection and positioning during total hip arthroplasty (THA); however, evidence for the usefulness of CAS in BHR is lacking. The present report summarizes a case of BHR performed with navigation to assist with component positioning.

A 34-year-old male martial arts instructor presented with a constant and localized pain in the left hip and groin. Following the examination, the patient was diagnosed with left hip impingement and osteoarthritis. Due to his age and active lifestyle, the patient elected to undergo BHR rather than THA. The navigation tool was used to assist with acetabular reaming and to confirm final cup placement. Post- operatively, standard, anteroposterior pelvic radiographs showed a final cup position of 39.0° inclination and 24.7° anteversion, which was confirmed by the navigation tool. A pre-operative leg length differential of 3mm was measured from pre-operative radiographs; however, leg lengths were equalized following BHR.

This report summarizes a case of BHR performed in a young, active patient with the assistance of a novel surgical navigation tool. The use of the navigation device allowed for more accurate acetabular preparation and component positioning, maximizing the bone-sparing characteristics of BHR.