title: Revision rate of Birmingham Hip Resurfacing arthroplasty: comparison of published literature and arthroplasty register data.
abstract: OBJECTIVE
  Hip resurfacing arthroplasty has gained popularity for treating young and active patients who have arthritis. There are two major data sources for assessing outcome and revision rate after total joint arthroplasty: sample-based clinical trials and national arthroplasty registers. The purpose of this study was to evaluate the outcome of the Birmingham Hip Resurfacing (BHR) arthroplasty in terms of revision rate as reported in clinical studies and recorded by national arthroplasty registers.
  
  
  METHODS
  A comprehensive literature research was performed from English-language, peer-reviewed journals and annual reports from national joint arthroplasty registers worldwide. Only publications from MEDLINE-listed journals were included. The revision rate was used as the primary outcome parameter. In order to allow for direct comparison of different data sets, calculation was based on revisions per 100 observed component years. For statistical analysis, confidence intervals (CI) were calculated.
  
  
  RESULTS
  A total of 18,708 implants, equivalent to 106,565 observed component years, were analysed in the follow-up studies. The register reports contained 9,806 primary cases corresponding to 44,294 observed component years. Statistical analysis revealed a significant difference in revisions per 100 observed component years between the development team (0.27; CI: 0.14-0.40) and register data (0.74; CI: 0.72-0.76).
  
  
  CONCLUSIONS
  The BHR arthroplasty device shows good results in terms of revision rate in register data as well as in clinical studies. However, the excellent results reported by the development team are not reproducible by other surgeons. Based on the results of our study, we believe that comprehensive national arthroplasty registers are the most suitable tool for assessing hip arthroplasty revision rate.
authors.affiliation: Department of Orthopaedics, Vienna General Hospital, Medical University of Vienna, Vienna, Austria. reinhard.schuh@meduniwien.ac.at
authors.forename: Reinhard
authors.initials: R
authors.lastname: Schuh
authors.forename: Daniel
authors.initials: D
authors.lastname: Neumann
authors.forename: Rauend
authors.initials: R
authors.lastname: Rauf
authors.forename: Jochen
authors.initials: J
authors.lastname: Hofstaetter
authors.forename: Nikolaus
authors.initials: N
authors.lastname: Boehler
authors.forename: Gerold
authors.initials: G
authors.lastname: Labek
mesh_terms: D001168:Arthritis / Q000601:surgery; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000706:statistics & numerical data; D019544:Equipment Failure Analysis; D006801:Humans; D016239:MEDLINE; D011475:Prosthesis Failure; D012042:Registries; D012086:Reoperation / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012196:Review Literature as Topic