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Birmingham Hip Resurfacing at 20 years.

Rohit Dhawan1, David A Young1, Anthony Van Eemeren1

  • 1Melbourne Orthopedic Group, Melbourne, Victoria, Australia.

The Bone & Joint Journal
|August 31, 2023
PubMed
Summary
This summary is machine-generated.

Birmingham Hip Resurfacing (BHR) arthroplasty shows excellent 20-year survival and functional outcomes, particularly in young male patients. Metal-on-metal implants were well-tolerated, with no pseudotumors observed in this cohort.

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Area of Science:

  • Orthopedic Surgery
  • Biomaterials Science
  • Clinical Outcomes Research

Background:

  • The Birmingham Hip Resurfacing (BHR) arthroplasty, a metal-on-metal hip resurfacing device, has been utilized for coxarthrosis since 1997.
  • Long-term data on BHR survivorship and patient outcomes are crucial for understanding its efficacy and safety profile.

Purpose of the Study:

  • To evaluate the 20-year clinical and radiographic outcomes of consecutive Birmingham Hip Resurfacing (BHR) arthroplasties.
  • To assess implant survivorship, functional scores, and serum metal ion levels at two decades post-implantation.

Main Methods:

  • A consecutive series of 234 Birmingham Hip Resurfacing (BHR) implants in 217 patients (1999-2001) were analyzed.
  • Data collected included patient-reported outcome measures, imaging (radiograph, ultrasound), serum metal ion assessment, and registry data for revision analysis.
  • Kaplan-Meier survivorship analysis was performed, with revision for any cause as the endpoint.

Main Results:

  • At a mean follow-up of 20.9 years, the cumulative implant survival rate was 96.5% for males and 87% for females (p=0.029).
  • Excellent functional outcomes were reported, with high scores on the Oxford Hip Score, Hip disability and Osteoarthritis Outcome Score, Forgotten Joint Score, and EuroQol 5-dimension 3-level questionnaire.
  • Ultrasound revealed no pseudotumors, and mean serum cobalt and chromium levels were within acceptable ranges, suggesting good tolerability.

Conclusions:

  • Birmingham Hip Resurfacing (BHR) arthroplasty demonstrates excellent long-term survivorship and functional outcomes, especially in younger male patients.
  • The metal-on-metal resurfacing implant appears to be well-tolerated at 20 years, with no significant soft-tissue complications or concerning metal ion levels.