Aims: To review the early results of Birmingham hip resurfacing (BHR). First 116 hips (98 patients). Materials: A cohort of consecutive patients prospectively underwent BHR in a single arthroplasty Surgeonñs practice in a University Hospital out side Birmingham. Inclusion criteria þt and active patients expected to out live conventional THR. 98 patients mean age 50 years (range 19–67). Pathology OA 85%, Perthes 7%, DDH 4.7% & SUFE 2%. Mean follow-up 30 months (range 12–45). Scoring systems used were Harris hip score (HHS), WOMAC & SF 36. Results: All patients under review, no radiological loosening.

HHS:Mean pre-arthroplasty score 47 (range 10–73), 1 yr score 99 (n=38), 2yr 97.3 (n=30) at 3yr 100 (n=26) & 4th yr 100 (n=4), this shows a statistically signiþcant improvement (P=0.001).

WOMAC: Pain: pre-op score 18.8, at 1 year 5.6 & 2nd year 5.7. Stiffness: pre-op 8.5, 1 year 2.7 & 2nd year 2.7. Physical: 49.3, 1 year 23.4 & 2nd year 22.6.

This shows a statistically signiþcant improvement in score (p=0.025) SF-36 Analysed against an age/sex match control group of normal values using a 2 tailed Ôtñ Test, seven of the eight domains showed no statistical signiþcant difference. Complications: One fracture following a fall, 2 AVN & early fractures (patients had deep cysts in proximal head now such patients are not offered BHR), one dislocation following RTA Conclusions: Birmingham hip resurfacing can provide excellent level of activity and patient satisfaction. Careful patient selection is needed. A long-term study is needed to evaluate the long-term beneþt and survivorship

Aim: To determine the Inter & Intra-observer Agreement in Assessment & Classiþcation of Non-unions of fractures based on Radiological appearance. Methods: X-rays of 100 adult patients with established non-union (NU) were selected by random sampling, excluding cases with poor quality x-rays. Common denominators of various classiþcation/assessment systems were selected for study. Observers were selected in 3 categories (2 in each): Senior Limb Reconstruction specialist, Musculoskeletal Radiologists & senior trainees. 6 weeks were allowed between the 2 sets of observations.

Data was analysed by calculating kappa coefþcients (95% CI) Results: Radiologists were unable to comment on vascularity.

Conclusion: Agreement in common denominators except hypertrophic/atrophic NU is poor. Radiographic analysis of non-union remains poor indicating the need for further study to see whether identiþable diagnostic, therapeutic & prognostic features exist