BHR, Birmingham, Birmingham Hip Resurfacing, Failure rate, Health, Hip Replacement, hip resurfacing, Journal of Bone and Joint Surgery, Medicine, NephewSmith, Oxford, oxford hip score, science, Smith & Nephew
26% Failure in Female Smith & Nephew BHR’s – and higher failure in older males…
The ten-year survival of the Birmingham hip resurfacing: An independent series.
Recent events have highlighted the importance of implant design for survival and wear-related complications following metal-on-metal hip resurfacing arthroplasty.
The mid-term survival of the most widely used implant, the Birmingham Hip Resurfacing (BHR), has been described by its designers.
The aim of this study was to report the ten-year survival and patient-reported functional outcome of the BHR from an independent centre. In this cohort of 554 patients (646 BHRs) with a mean age of 51.9 years (16.5 to 81.5) followed for a mean of eight years (1 to 12), the survival and patient-reported functional outcome depended on gender and the size of the implant.
In female hips (n = 267) the ten-year survival was 74% (95% confidence interval (CI) 83 to 91), the ten-year revision rate for pseudotumour was 7%, the mean Oxford hip score (OHS) was 43 (sd 8) and the mean UCLA activity score was 6.4 (sd 2).
[Earlsview note - this means 26% failure rate for female recipients of BHR's]
In male hips (n = 379) the ten-year survival was 95% (95% CI 92.0 to 97.4), the ten-year revision rate for pseudotumour was 1.7%, the mean OHS was 45 (sd 6) and the mean UCLA score was 7.6 (sd 2).
In the most demanding subgroup, comprising male patients aged < 50 years treated for primary osteoarthritis, the survival was 99% (95% CI 97 to 100).
[Earlsview note - so how many young men? Also this means that the failure rate in the >50 yr males was higher than 5% reported above. BUT what was it?]
This study supports the ongoing use of resurfacing in young active men, who are a subgroup of patients who tend to have problems with conventional THR.
In contrast, the results in women have been poor and we do not recommend metal-on-metal resurfacing in women. Continuous follow-up is recommended because of the increasing incidence of pseudotumour with the passage of time.
- [PubMed - in process]
- 26% Failure in Female Smith & Nephew BHR’s – The ten-year survival of the Birmingham… [J Bone Joint Surg Br. 2012] – PubMed – NCBI (earlsview.com)
- Smith & Nephew Birmingham hip resurfacing at a mean of ten years (earlsview.com)
- Ban ‘failing’ hip resurfacing implants for women, say surgeons | Mail Online (earlsview.com)
- Hip Resurfacing Draws Warning After Study Published in Lancet – NYTimes.com (earlsview.com)
- Early Clinical Failure of the Birmingham Metal-on-metal Hip Resurfacing Is Associated With Metalosis and Soft Tissue Necrosis (earlsview.com)
- Hip resurfacing ‘prone to fail’ (bbc.co.uk)
- Interview with Derek McMinn and Ronan Treacy – Orthopaedic Product News (earlsview.com)
- Unacceptably High Failure Rates Found In Hip Resurfacing Operations (medicalnewstoday.com)
- Hip replacement method ‘unacceptable’ for women (telegraph.co.uk)
- Smith & Nephew BHR – A benign psoas mass following metal-on-metal resurfacing of the hip (earlsview.com)