Ten-year results show effectiveness of resurfacing technology

Published date : 03 February 2011
Article date : 03 February 2011

The January edition of the British Volume of the Journal of Bone and Joint Surgery carries ten year results of a single series of Birmingham Hip Resurfacings from Ronan Treacy, one of the designers and a long term advocate of the device. This series of 144 resurfacings followed up at ten years include his personal “learning curve” and some of the failures relate to technical aspects (such as cup anteversion), the importance of which has only become apparent over the last few years. Patients in the series are predominantly male, for whom the ten year survival of the implant was 98.0%. Problems in the 37 female patients included 8 failures, amongst which were 3 infections and a revision required in one patient who was 70 at the time of resurfacing – not many surgeons would offer resurfacings to patients of this age.

For comparison, the seventh UK National Joint Registry report quoted 5 year revision rates in males under 55 years as 4.4% (3.2% to 6.0%) for cemented hip implants, 4.0% (3.1% to 5.1%) for uncemented implants, 2.6% (1.7% to 3.8%) with hybrid, 5.6% (4.5% to 6.9%) with hip resurfacing (within which group the BHR had the best results – see also results of Conserve Plus – 88.5% survival at ten years (Amstutz et al, 2010)) and 6.4% (4.5% to 8.9%) with large bearing metal on metal hip replacement. The point is made however, that these are 10, rather than 5 year results. In this and other series, smaller components are associated with poorer outcomes.

So what to do when faced with a young patient with hip osteoarthritis? There are alternative approaches (eg custom femoral stem, 97.3% overall 10 year survival, (Muirhead-Allwood 2010), but whether or not you choose a Birmingham Hip Resurfacing, may relate to whether or not you are a believer.


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