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Australia, Bachelor of Medicine Bachelor of Surgery, Birmingham, hip, Hip Replacement, hip resurfacing, NephewSmith, S. Pearce
Birmingham hip resurfacing at a mean of ten years.
Birmingham hip resurfacing at a mean of ten years
Results from an independent centre
G. Coulter, MBChB, FRACS, Orthopaedic Fellow1; D. A. Young, MBBS, FRACS, FAOrthA, Orthopaedic Surgeon1; R. E. Dalziel, MBBS, FRACS, FAOrthA, Orthopaedic Surgeon1; and A. J. Shimmin, MBBS, FRACS, FAOrthA, Orthopaedic Surgeon1
+ Author Affiliations
1Melbourne Orthopaedic Group, 33 The Avenue Windsor, Melbourne 3181, Australia.
Correspondence should be sent to Mr A. J. Shimmin; e-mail: ashimmin@optusnet.com.au
Abstract
We report the findings of an independent review of 230 consecutive Birmingham hip resurfacings (BHRs) in 213 patients (230 hips) at a mean follow-up of 10.4 years (9.6 to 11.7).
A total of 11 hips underwent revision; six patients (six hips) died from unrelated causes; and 13 patients (16 hips) were lost to follow-up. The survival rate for the whole cohort was 94.5% (95% confidence interval (CI) 90.1 to 96.9).
The survival rate in women was 89.1% (95% CI 79.2 to 94.4) and in men was 97.5% (95% CI 92.4 to 99.2).
Women were 1.4 times more likely to suffer failure than men.
For each millimetre increase in component size there was a 19% lower chance of a failure. The mean Oxford hip score was 45.0 (median 47.0, 28 to 48); mean University of California, Los Angeles activity score was 7.4 (median 8.0, 3 to 9); mean patient satisfaction score was 1.4 (median 1.0, 0 to 9).
A total of eight hips had lysis in the femoral neck and two hips had acetabular lysis. One hip had progressive radiological changes around the peg of the femoral component. There was no evidence of progressive neck narrowing between five and ten years.
Our results confirm that BHR provides good functional outcome and durability for men, at a mean follow-up of ten years. We are now reluctant to undertake hip resurfacing in women with this implant.
Footnotes
The authors wish to thank Professor A. Esterman and Dr S. Pearce for statistical analysis of the study data, and A. Pearce for assistance with the preparation of the manuscript.
No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
Received August 19, 2011.
Accepted November 1, 2011.
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How do you NOT find 16 hips?
You have to wonder?
I wonder if the patient group were 18-21 years of age as they appear to be in the post approval data supplied by the manufacturer.
Also as a reminder one of the stipulations of the ” SPECIAL ” pma approval of the bhr by the FDA was Smith & Nephew was to report adverse affects, all of them, to the FDA.
Perhaps some of these were over looked or maybe they are with the 16 missing hips.
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