The ten-year survival of the Birmingham hip resurfacing

An independent series

D W Murray, G Grammatopoulos, H Pandit, R Gundle, H S Gill, P McLardy-Smith

Research output: Contribution to journalArticle

77 Citations (Scopus)

Abstract

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). 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). 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.
Original languageEnglish
Pages (from-to)1180-1186
Number of pages7
JournalJournal of Bone and Joint Surgery - British Volume
Volume94
Issue number9
DOIs
Publication statusPublished - 2012

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Hip
Survival
Metals
Confidence Intervals
Osteoarthritis
Arthroplasty
Incidence

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The ten-year survival of the Birmingham hip resurfacing : An independent series. / Murray, D W; Grammatopoulos, G; Pandit, H; Gundle, R; Gill, H S; McLardy-Smith, P.

In: Journal of Bone and Joint Surgery - British Volume, Vol. 94, No. 9, 2012, p. 1180-1186.

Research output: Contribution to journalArticle

Murray, D W ; Grammatopoulos, G ; Pandit, H ; Gundle, R ; Gill, H S ; McLardy-Smith, P. / The ten-year survival of the Birmingham hip resurfacing : An independent series. In: Journal of Bone and Joint Surgery - British Volume. 2012 ; Vol. 94, No. 9. pp. 1180-1186.
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abstract = "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). 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). 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.",
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