Results of BHRs at 12 to 15 years – Mr. McMinn 2014
June 2014
Original Study Here:
J. Daniel, FRCS, MS(Orth), DNBOrth, Director of Research, Staff Orthopaedic
Surgeon1 Author Profile;
C. Pradhan, FRCS, MCh(Orth), Staff Orthopaedic Surgeon2;
H. Ziaee, BSc (Hons), Biomedical Scientist1;
P. B. Pynsent, PhD, Director, Research and Training Centre2; and
D. J. W. McMinn, MD FRCS, Consultant Orthopaedic Surgeon1
Abstract
We report a 12 to 15 year implant survival assessment of a prospective
single-surgeon series of Birmingham Hip Resurfacings (BHRs). The earliest 1000
consecutive BHRs including 288 women (335 hips) and 598 men (665 hips) of all
ages and diagnoses with no exclusions were prospectively followed-up with postal
questionnaires, of whom the first 402 BHRs (350 patients) also had clinical and
radiological review.
Mean follow-up was 13.7 years (12.3 to 15.3). In total, 59 patients (68 hips)
died 0.7 to 12.6 years following surgery from unrelated causes. There were 38
revisions, 0.1 to 13.9 years (median 8.7) following operation, including 17
femoral failures (1.7%) and seven each of infections, soft-tissue reactions and
other causes. With revision for any reason as the end-point Kaplan-Meier
survival analysis showed 97.4% (95% confidence interval (CI) 96.9 to 97.9) and
95.8% (95% CI 95.1 to 96.5) survival at ten and 15 years, respectively.
Radiological assessment showed 11 (3.5%) femoral and 13 (4.1%) acetabular
radiolucencies which were not deemed failures and one radiological femoral
failure (0.3%).
Our study shows that the performance of the BHR continues to be good at 12- to
15-year follow-up. Men have better implant survival (98.0%; 95% CI 97.4 to 98.6)
at 15 years than women (91.5%; 95% CI 89.8 to 93.2), and women < 60 years
(90.5%; 95% CI 88.3 to 92.7) fare worse than others. Hip dysplasia and
osteonecrosis are risk factors for failure. Patients under 50 years with
osteoarthritis fare best (99.4%; 95% CI 98.8 to 100 survival at 15 years), with
no failures in men in this group.