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Birmingham Hip Resurfacing (BHR) offers a durable metal-on-metal (MoM) hip resurfacing option, especially for younger males with osteoarthritis, showing comparable results to total hip arthroplasty (THA) at 25 years.

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Area of Science:

  • Orthopedic Surgery
  • Biomaterials Science
  • Reconstructive Surgery

Background:

  • The Birmingham Hip Resurfacing (BHR) was developed for young, active patients requiring hip joint replacement.
  • Previous reports detailed outcomes at 5 and 10 years for this metal-on-metal (MoM) bearing implant.
  • This study aimed to provide a long-term 25-year follow-up of the initial BHR cohort.

Purpose of the Study:

  • To evaluate the 25-year survival and outcomes of the Birmingham Hip Resurfacing (BHR) implant.
  • To assess implant survivorship and patient-reported outcomes in a cohort treated between 1997 and 1998.
  • To compare the long-term efficacy of BHR with established hip replacement procedures.

Main Methods:

  • A 25-year follow-up of 130 patients (144 hips) who underwent BHR for various indications.
  • Kaplan-Meier survival analysis was used to determine implant survival rates.
  • Routine follow-up included serum metal ion levels, radiographs, and Oxford Hip Scores (OHSs).

Main Results:

  • Overall implant survival at 25 years was 83.50%, with significantly higher survival in males (89.5%) than females (66.9%).
  • Ten additional failures occurred between 10 and 25 years, including adverse reactions to metal debris, periprosthetic fractures, and aseptic loosening.
  • Median serum chromium and cobalt levels were 49.50 nmol/l and 42 nmol/l, respectively; median Oxford Hip Score was 35.

Conclusions:

  • Metal-on-metal (MoM) hip resurfacing with the BHR demonstrates durability and serves as a viable alternative to total hip arthroplasty (THA).
  • The BHR implant is particularly effective for younger male patients with osteoarthritis seeking to maintain high function.
  • Long-term results suggest favorable outcomes comparable to the best total hip arthroplasty (THA) series.