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EARLY RESULTS OF PRIMARY BIRMINGHAM HIP RESURFACING USING A HYBRID METAL-ON-METAL COUPLE.



Abstract

We present the results of our initial experience with the use of the Birmingham metal-on-metal Hip Resurfacing. The Birmingham Hip Resurfacing(BHR) consists of a high carbon chrome cobalt uncemented hydroxyapatite cupand a cemented femoral component. For patients with severe dysplasia adysplasia cup with screws was used. We utilise this kind of prosthesis for the younger patients (< 65 year). Excellent clinical results are encountered; none of the early problems aswith the old Wagner resurfacing (metal-on-poly) are seen. Our early results are similar to the encouraging results of the series of D.McMinn/R.Treacy.

From September 1998 through April 2001, 185 BHR arthroplasties were performed. The mean age was 49.7 year (16–75). More male patients were operated with this method than female patients (64%–36%). The aetiology was osteoarthritis (81%), necrosis (9%), dysplasia (CDH) (6.6%).

Results: The last 115 patients were reviewed with a follow up from 1 month to 2.5year. Only two patients were lost for follow-up because of death. There was no pain in 92.3% of the cases. The total Harris Hip Score had a mean of97.91, a median score of 100 (71–100). Merle d’Aubigné total Score was 17.36 (12–18). There was a strenuous activity in 70.2% of the patients.

The mean length of stay in hospital was six days (range: 2–26). Complications were: One fractured neck of femur, one ischial nerve palsy and one guide pin was left in the femur. All patients were followed on regular basis and the X-rays were studied for angle of preoperative neck of femur, postoperative angle of the femoral component, angle of cup placement and the parallelism of both components.

Conclusion: Performing only alternate bearings in patients under the age of 75, the metal-on-metal Birmingham Hip Resurfacing looks a good alternative in young active patients and the results are promising.

The abstracts were prepared by Nico Verdonschot. Correspondence should be addressed to him at Orthopaedic Research Laboratory, University Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands.