Abstract
Introduction: The Birmingham Hip Resurfacing (BHR) device was introduced in 1997 as a conservative hip arthroplasty option for young patients with severe arthritis. Primary osteoarthritis is the most common etiology of hip arthritis in the West. Excellent early and medium-term results have been reported with the BHR. This is a 9–year review of the first 100 consecutive BHRs performed by one surgeon (DJWM) for primary OA.
Methods: The first 100 BHRs (91 patients) performed for OA are now at a mean follow-up of 9.1 (range 8.9 to 9.3) years. Four patients (5 hips) died 5.2 to 6.9 years later due to unrelated causes. Patients with unrevised hips were reviewed clinico-radiologically and with questionnaire assessment.
Results: With revision for any reason as the end-point there were four failures (two were post-operative AVN leading to femoral head collapse, 8 months and 7 years after their respective operations; and two were deep infections both 5 years after operation). Kaplan-Meier survival analysis showed a 96% cumulative survival at 9 years (figure). There were no failures from osteolysis or aseptic loosening and no patient is awaiting a revision for any reason.
Discussion: The performance of the BHR continues to be good at 9 years. Arthroplasty devices are known to manifest two phases of failure, one in the early years and another in the later years. Early failure with this device has been very low. The interim years are continuing to be promising and we are yet to find out when the late failures, if any, are likely to occur.
Correspondence should be addressed to Mr John Hodgkinson, BHS, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.
