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.