title: Clinical and radiographic outcomes of the Birmingham Hip Resurfacing arthroplasty at a minimum follow-up of 10 years: results from an independent centre.
abstract: BACKGROUND
  Metal-on-metal hip resurfacing (MoMHR) has been proposed as an effective surgical treatment for young and active patients with symptomatic hip disease. Recently, good clinical and radiographic outcomes have been reported by the designer surgeons at a 15.3 years follow-up; however, results at long follow-up by non-designer surgeons are less satisfactory. The aim of the study was to investigate if MoMHR can produce satisfactory clinical and radiographic results and if survival rate can be high even if the procedure is performed by non-designer surgeons.
  
  
  METHODS
  All patients were assessed about implant survival. All patients completed an Oxford Hip Score (OHS), Harris Hip Score (HHS) and a University of California Los Angeles (UCLA) activity score preoperatively, at 1 year and at last available follow-up; at this time, a standard anteroposterior weight-bearing radiograph was performed.
  
  
  RESULTS
  The survival rate with revision for any reason is 96%, similar to those obtained by designer surgeons. All the clinical scores improved over time: according to the OHS the survivors are asymptomatic and according to the UCLA maintain a high level of function. 6 remodellings of the femoral neck and 2 heterotopic bone formations were seen, but they were asymptomatic.
  
  
  CONCLUSIONS
  As designer surgeons have already shown, MoMHR can provide in active patients a durable treatment for hip arthritis, with low risk of revision and good results at 10 years follow-up, even if the procedure is performed by non-designer surgeons.
authors.affiliation: Vita-Salute San Raffaele University, Milan - Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Moroni
authors.affiliation: Vita-Salute San Raffaele University, Milan - Italy.
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Miscione
authors.affiliation: Vita-Salute San Raffaele University, Milan - Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Orsini
authors.affiliation: Vita-Salute San Raffaele University, Milan - Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Micera
authors.affiliation: Vita-Salute San Raffaele University, Milan - Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Mosca
authors.affiliation: Vita-Salute San Raffaele University, Milan - Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Sinapi
authors.affiliation: IRCCS (Institutes for Research, Hospitalisation and Health Care) Galeazzi, Milan - Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: De Girolamo
authors.affiliation: Vita-Salute San Raffaele University, Milan - Italy.|IRCCS (Institutes for Research, Hospitalisation and Health Care) Galeazzi, Milan - Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Banfi
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000367:Age Factors; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods*; D002140:California; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006621:Hip Joint / Q000503:physiopathology / Q000601:surgery; D006622:Hip Prosthesis; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D061825:Metal-on-Metal Joint Prostheses; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000000981:diagnostic imaging / Q000601:surgery*; D016016:Proportional Hazards Models; D011475:Prosthesis Failure; D011859:Radiography / Q000379:methods; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors; D016896:Treatment Outcome