Authors: Md Quamar Azam Stephen McMahon Gabrielle Hawdon Sukesh Rao Sankineani
Publish Date: 2015/03/31
Volume: 40, Issue: 1, Pages: 1-7
Abstract
Resurfacing as a percentage of total hip arthroplasty rose from 56 in 2001 to 89 in 2005 in Australia During the same period the resurfacing to conventional prosthesis rose from 196 to 29 in the younger age group less than 55 years Long term more than ten years functional results of BHR are sparingly documented Among the literatures available the patient selection criteria vary from osteoarthritis avascular necrosis and dysplastic hip to slipped capital femoral epiphysis The objective of the current study is to evaluate long term survivorship and functional outcome of Birmingham hip resurfacing surgery in osteoarthritic hip patients performed by a single surgeonIn this retrospective clinical study all patients who underwent hip resurfacing for osteoarthritis of hip between 1999 and 2004 are included All surgeries were performed by single surgeon SJM and in all patients Smith Nephew system Midland Medical Technologies Birmingham United Kingdom was used Revision surgery is considered the end point of survivorship Means standard deviations and confidence interval were calculated for all continuous measures Survival analysis was performed with the Kaplan–Meier method and 95 confidence intervals were calculatedThe result is based on 222 patients 244 hips This included 153 males and 69 females Our mean follow up was 1205 years and overall survival was 937 In terms of gender survival in males was 9543 while in females it was 8986 Failure was seen in 14 patients 16 hips which included seven female 1014 and seven male 457 patients Failure of femoral components due to aseptic loosening and varus collapse was seen in eight patients after a mean 96 years Metal allergy was seen in three patients five hips all of them were female of which two had bilateral resurfacing Other complications included femoral neck stress fractures in two patients and acetabular component loosening in one patient We observed that the failure rate is higher if the BHR femoral component size is 46 or less ten out of 16 hips revisedIf patient selection is judiciously done and surgical technique is meticulously followed hip resurfacing offers acceptable survivorship satisfactory range of motion and enables patients to resume high demand activities including sports Future improvements in the bearing surfaces and possibly in the design might alleviate concerns posed by high serum metal level and provide options that continue to benefit younger patients in future
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