The metal-on-metal total hip resurfacing arthroplasty is a good solution for the younger patient with osteoarthritis of the hip. It is effective in pain resolution and provides a good function.

Our study of 300 BHR arthroplasties with a follow-up of 2 to 7 year shows good results in a young and active population.

With an overall survival of 96.7% we obtained similar results to those of the design centre. The overall postoperative HHS score of 95.78 +/− 12.63 is in line with other studies. We noticed a similar increase in HHS in female patients and male patients.

Even in the HOOS scores there was no significant difference between both groups. This is an important finding for the surgeon as well as the patients.

Looking at the VAS scores for satisfaction or reoperation we could state that the high expectations of this population have been fulfilled.

With have an acceptable revision rate of 2.42% the patients undergoing a revision were of a simular mean age than those in the overall group. Five of them are female, two are male. Since there were twice as many female as male patients there is little difference in revision percentage between both groups.

There was 1 patient with a bilateral revision because of ALVAL (aseptic lymphocytic vasculitis associated lesion).

Although femoral neck fractures are a known complication, there where none in our series.

Patients are able to lead an active life and perform sports. The postoperative benefits are equal in men and women. The satisfaction rate confirms that we are able to meet the expectations in this high demand group.

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.