title: Results of Birmingham hip resurfacing at 12 to 15 years: a single-surgeon series.
abstract: We report a 12- to 15-year implant survival assessment of a prospective single-surgeon series of Birmingham Hip Resurfacings (BHRs). The earliest 1000 consecutive BHRs including 288 women (335 hips) and 598 men (665 hips) of all ages and diagnoses with no exclusions were prospectively followed-up with postal questionnaires, of whom the first 402 BHRs (350 patients) also had clinical and radiological review. Mean follow-up was 13.7 years (12.3 to 15.3). In total, 59 patients (68 hips) died 0.7 to 12.6 years following surgery from unrelated causes. There were 38 revisions, 0.1 to 13.9 years (median 8.7) following operation, including 17 femoral failures (1.7%) and seven each of infections, soft-tissue reactions and other causes. With revision for any reason as the end-point Kaplan-Meier survival analysis showed 97.4% (95% confidence interval (CI) 96.9 to 97.9) and 95.8% (95% CI 95.1 to 96.5) survival at ten and 15 years, respectively. Radiological assessment showed 11 (3.5%) femoral and 13 (4.1%) acetabular radiolucencies which were not deemed failures and one radiological femoral failure (0.3%). Our study shows that the performance of the BHR continues to be good at 12- to 15-year follow-up. Men have better implant survival (98.0%; 95% CI 97.4 to 98.6) at 15 years than women (91.5%; 95% CI 89.8 to 93.2), and women < 60 years (90.5%; 95% CI 88.3 to 92.7) fare worse than others. Hip dysplasia and osteonecrosis are risk factors for failure. Patients under 50 years with osteoarthritis fare best (99.4%; 95% CI 98.8 to 100 survival at 15 years), with no failures in men in this group.
authors.affiliation: The McMinn Centre, 25 Highfield Road, Birmingham, B15 3DP, UK.
authors.forename: J
authors.initials: J
authors.lastname: Daniel
authors.affiliation: Royal Orthopaedic Hospital, The Woodlands, Bristol Road South, Birmingham, B31 2AP, UK.
authors.forename: C
authors.initials: C
authors.lastname: Pradhan
authors.affiliation: The McMinn Centre, 25 Highfield Road, Birmingham, B15 3DP, UK.
authors.forename: H
authors.initials: H
authors.lastname: Ziaee
authors.affiliation: Royal Orthopaedic Hospital, The Woodlands, Bristol Road South, Birmingham, B31 2AP, UK.
authors.forename: P B
authors.initials: PB
authors.lastname: Pynsent
authors.affiliation: The McMinn Centre, 25 Highfield Road, Birmingham, B15 3DP, UK.
authors.forename: D J W
authors.initials: DJ
authors.lastname: McMinn
mesh_terms: D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006621:Hip Joint / Q000503:physiopathology*; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000601:surgery*; D011446:Prospective Studies; D011474:Prosthesis Design; D011475:Prosthesis Failure; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function; D012086:Reoperation / Q000379:methods; D016896:Treatment Outcome
keywords: Adverse reactions; Hip dysplasia; Hip resurfacing; Metal debris; Osteoarthrosis; Osteonecrosis; Radiology; Survivorship