We report the outcome at a minimum of five years of 110 consecutive metal-on-metal Birmingham Hip Resurfacing arthroplasties in 98 patients. The procedures were performed between October 1999 and June 2002 by one surgeon. All patients were followed up clinically and radiologically. The mean follow-up was 71 months (60 to 93). Revision of either component was defined as failure.

The mean Harris Hip score at follow-up was 96.4 (53 to 100). The mean Oxford hip score was 41.9 (16 to 57) pre-operatively and 15.4 (12 to 49) post-operatively (p < 0.001). The mean University of California Los Angeles activity score was 3.91 (1 to 10) pre-operatively and 7.5 (4 to 10) post-operatively (p < 0.001).

There were four failures giving a survival at five years of 96.3% (95% confidence interval 92.8 to 99.8). When applying a new method to estimate narrowing of the femoral neck we identified a 10% thinning of the femoral neck in 16 hips (14.5%), but the relevance of this finding to the long-term outcome remains unclear.

These good medium-term results from an independent centre confirm the original data from Birmingham.

Venous ulceration is a chronic disabling complication of deep-vein thrombosis. The aim of this study was to estimate the incidence of venous leg ulcers five years or more after total hip replacement (THR) and to investigate some of the clinical features associated with their development.

We carried out a postal survey of all patients who had undergone a THR 5 to 12 years previously. Replies from 816 patients showed that 66 (8.1%) had a history of leg ulcers. The prevalence of active ulceration was 2.6% and 43 patients (5.3%) reported developing ulceration since their hip replacement. A clinical review determined that 31 (3.8%) of these were true venous ulcers. The ulcers occurred more commonly on the operated side and developed at a mean of 5.8 years (18 months to 12 years) after the first arthroplasty. A mean of 1.9 arthroplasties (1 to 5) (primary and revision) were carried out before the ulcers appeared. The overall incidence of ulcers was similar to that in the general population.

We describe a patient who sustained a peri-prosthetic fracture of the femoral neck two weeks after undergoing a resurfacing procedure for osteoarthritis of the hip. The fracture was minimally displaced and a satisfactory outcome was obtained following conservative treatment.