Birmingham Hip Resurfacing at 25 years

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.