Abstract
Background
Hip resurfacing has resurged in the last decade due to a renewed interest in metal on metal bearing. One of the proposed advantages is ease of revision of the femoral component. Short term functional results after femoral revision are similar to those after conventional total hip replacement. Survival and function after revision of the acetabular component only or of both components have not been reported. We aimed to assess hip function and implant survival after revision of the acetabular component for failed Birmingham hip resurfacing (BHR).
Methods
The Oswestry Outcome Centre collected data prospectively on 5000 patients who underwent hip resurfacing between 1997 and 2002. Of these, 182 hips were revised: 42% had revision of the femoral component only, 8% revision of the acetabular component only, and 50% revision of both components. This study analyzed patients who had revision of the acetabular component, either in isolation or in combination with the femoral component.
Results
In the isolated acetabular revision group the median Harris Hip Score was 74 at a mean of 4.5 years post-revision. In the both components revision group the median Harris hip score was 85 at a mean of 4 years. There was no significant difference in function between the groups. Kaplan-Meier survivor ship analysis after revision showed an average survival of 91% at 10 years. There was a significant difference between survival of isolated acetabular revision (75%) and both component revision (96%).
Conclusions
Revision total hip replacement subsequent to failure of hip resurfacing has good outcome and good midterm survival. Isolated acetabular revision and revision of both components had similar function but survival was significantly worse in the isolated acetabular revision group.
