Birmingham Hip Resurfacing: a retrospective cohort study of clinical, biochemical, and radiological outcomes in a non-designer centre at minimum 15 years’ follow-up
Aims: Although the use of metal-on-metal (MoM) implants in total hip arthroplasty (THA) remains a topic of controversy, prior literature has reported satisfactory ten-year clinical and radiological outcomes following Birmingham Hip Resurfacing (BHR), subsequently resulting in a recent Orthopaedic D...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
The British Editorial Society of Bone & Joint Surgery
2025-04-01
|
| Series: | Bone & Joint Open |
| Subjects: | |
| Online Access: | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.64.BJO-2025-0003.R1 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850140510495178752 |
|---|---|
| author | Martin S. Davey Conor Farrell Conor Kilkenny Conor Medlar Niall P. McGoldrick John F. Quinlan |
| author_facet | Martin S. Davey Conor Farrell Conor Kilkenny Conor Medlar Niall P. McGoldrick John F. Quinlan |
| author_sort | Martin S. Davey |
| collection | DOAJ |
| description | Aims: Although the use of metal-on-metal (MoM) implants in total hip arthroplasty (THA) remains a topic of controversy, prior literature has reported satisfactory ten-year clinical and radiological outcomes following Birmingham Hip Resurfacing (BHR), subsequently resulting in a recent Orthopaedic Data Evaluation Panel (ODEP) rating of 15 A*. Therefore, the purpose of this study was to evaluate the functional outcomes, radiological outcomes, and revision rates following BHR at a minimum of 15 years’ follow-up in a non-designer centre. Methods: Two investigators performed a retrospective review to identify consecutive patients who underwent BHR in our institution over a seven-year period (2003 to 2009, at minimum 15 years’ follow-up) in a non-designer centre. Evaluation of clinical (Oxford Hip Scores (OHS)), biochemical (cobalt and chromium levels), and radiological (plain film radiographs) outcomes was carried out. Survivorship analysis was performed using Kaplan-Meier curves, with all-cause surgical revision defined as a definitive endpoint for analysis. Descriptive statistical analysis was carried out. Results: Overall, 96 patients (86 males) at a mean age of 51.4 years (SD 9.9; 27 to 69) underwent 105 BHR procedures (nine bilateral) with at least 15 years’ minimum follow-up. Mean OHS was 38.3 (SD 9.6; 17 to 48) at 15-year minimum follow-up. The overall survivorship was 94.3% at 15 years post BHR, with an all-cause revision rate of 5.7%. Only eight BHR prostheses (8.2%) had radiolucent lines on plain films, none of which were listed for revision at the time of latest follow-up, while 32 patients had undergone MRI at 170 months (SD 54.9; 6 to 249) post BHR, with evidence of fluid collection, aseptic lymphocyte-dominant vasculitis-associated lesion, and metallosis identified on the MRI of four patients, four patients, and one patient, respectively. For 98.4% (60/61) of patients, cobalt and chromium values were either within normal limits (68.9%, n = 42) or less than double the upper limit of normal (29.5%, n = 18). Conclusion: This study found that BHR demonstrates an acceptable survivorship of 94% at 15 years of minimum follow-up, with satisfactory clinical and radiological outcomes to reflect this low all-cause revision rate in a non-designer centre. Cite this article: Bone Jt Open 2025;6(4):413–418. |
| format | Article |
| id | doaj-art-b4982614df4647e782f71f3c843a219f |
| institution | OA Journals |
| issn | 2633-1462 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | The British Editorial Society of Bone & Joint Surgery |
| record_format | Article |
| series | Bone & Joint Open |
| spelling | doaj-art-b4982614df4647e782f71f3c843a219f2025-08-20T02:29:46ZengThe British Editorial Society of Bone & Joint SurgeryBone & Joint Open2633-14622025-04-016441341810.1302/2633-1462.64.BJO-2025-0003.R1Birmingham Hip Resurfacing: a retrospective cohort study of clinical, biochemical, and radiological outcomes in a non-designer centre at minimum 15 years’ follow-upMartin S. Davey0Conor Farrell1Conor Kilkenny2Conor Medlar3Niall P. McGoldrick4John F. Quinlan5Tallaght University Hospital, Dublin, IrelandTallaght University Hospital, Dublin, IrelandTallaght University Hospital, Dublin, IrelandTallaght University Hospital, Dublin, IrelandTallaght University Hospital, Dublin, IrelandTallaght University Hospital, Dublin, IrelandAims: Although the use of metal-on-metal (MoM) implants in total hip arthroplasty (THA) remains a topic of controversy, prior literature has reported satisfactory ten-year clinical and radiological outcomes following Birmingham Hip Resurfacing (BHR), subsequently resulting in a recent Orthopaedic Data Evaluation Panel (ODEP) rating of 15 A*. Therefore, the purpose of this study was to evaluate the functional outcomes, radiological outcomes, and revision rates following BHR at a minimum of 15 years’ follow-up in a non-designer centre. Methods: Two investigators performed a retrospective review to identify consecutive patients who underwent BHR in our institution over a seven-year period (2003 to 2009, at minimum 15 years’ follow-up) in a non-designer centre. Evaluation of clinical (Oxford Hip Scores (OHS)), biochemical (cobalt and chromium levels), and radiological (plain film radiographs) outcomes was carried out. Survivorship analysis was performed using Kaplan-Meier curves, with all-cause surgical revision defined as a definitive endpoint for analysis. Descriptive statistical analysis was carried out. Results: Overall, 96 patients (86 males) at a mean age of 51.4 years (SD 9.9; 27 to 69) underwent 105 BHR procedures (nine bilateral) with at least 15 years’ minimum follow-up. Mean OHS was 38.3 (SD 9.6; 17 to 48) at 15-year minimum follow-up. The overall survivorship was 94.3% at 15 years post BHR, with an all-cause revision rate of 5.7%. Only eight BHR prostheses (8.2%) had radiolucent lines on plain films, none of which were listed for revision at the time of latest follow-up, while 32 patients had undergone MRI at 170 months (SD 54.9; 6 to 249) post BHR, with evidence of fluid collection, aseptic lymphocyte-dominant vasculitis-associated lesion, and metallosis identified on the MRI of four patients, four patients, and one patient, respectively. For 98.4% (60/61) of patients, cobalt and chromium values were either within normal limits (68.9%, n = 42) or less than double the upper limit of normal (29.5%, n = 18). Conclusion: This study found that BHR demonstrates an acceptable survivorship of 94% at 15 years of minimum follow-up, with satisfactory clinical and radiological outcomes to reflect this low all-cause revision rate in a non-designer centre. Cite this article: Bone Jt Open 2025;6(4):413–418.https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.64.BJO-2025-0003.R1birminghamhip resurfacinglong-term15 yearsnon-designer centrebirmingham hip resurfacingradiological outcomesmris scansoxford hip scores (ohs)chromiumcobaltfunctional outcomesradiolucent linesradiographsmetallosis |
| spellingShingle | Martin S. Davey Conor Farrell Conor Kilkenny Conor Medlar Niall P. McGoldrick John F. Quinlan Birmingham Hip Resurfacing: a retrospective cohort study of clinical, biochemical, and radiological outcomes in a non-designer centre at minimum 15 years’ follow-up Bone & Joint Open birmingham hip resurfacing long-term 15 years non-designer centre birmingham hip resurfacing radiological outcomes mris scans oxford hip scores (ohs) chromium cobalt functional outcomes radiolucent lines radiographs metallosis |
| title | Birmingham Hip Resurfacing: a retrospective cohort study of clinical, biochemical, and radiological outcomes in a non-designer centre at minimum 15 years’ follow-up |
| title_full | Birmingham Hip Resurfacing: a retrospective cohort study of clinical, biochemical, and radiological outcomes in a non-designer centre at minimum 15 years’ follow-up |
| title_fullStr | Birmingham Hip Resurfacing: a retrospective cohort study of clinical, biochemical, and radiological outcomes in a non-designer centre at minimum 15 years’ follow-up |
| title_full_unstemmed | Birmingham Hip Resurfacing: a retrospective cohort study of clinical, biochemical, and radiological outcomes in a non-designer centre at minimum 15 years’ follow-up |
| title_short | Birmingham Hip Resurfacing: a retrospective cohort study of clinical, biochemical, and radiological outcomes in a non-designer centre at minimum 15 years’ follow-up |
| title_sort | birmingham hip resurfacing a retrospective cohort study of clinical biochemical and radiological outcomes in a non designer centre at minimum 15 years follow up |
| topic | birmingham hip resurfacing long-term 15 years non-designer centre birmingham hip resurfacing radiological outcomes mris scans oxford hip scores (ohs) chromium cobalt functional outcomes radiolucent lines radiographs metallosis |
| url | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.64.BJO-2025-0003.R1 |
| work_keys_str_mv | AT martinsdavey birminghamhipresurfacingaretrospectivecohortstudyofclinicalbiochemicalandradiologicaloutcomesinanondesignercentreatminimum15yearsfollowup AT conorfarrell birminghamhipresurfacingaretrospectivecohortstudyofclinicalbiochemicalandradiologicaloutcomesinanondesignercentreatminimum15yearsfollowup AT conorkilkenny birminghamhipresurfacingaretrospectivecohortstudyofclinicalbiochemicalandradiologicaloutcomesinanondesignercentreatminimum15yearsfollowup AT conormedlar birminghamhipresurfacingaretrospectivecohortstudyofclinicalbiochemicalandradiologicaloutcomesinanondesignercentreatminimum15yearsfollowup AT niallpmcgoldrick birminghamhipresurfacingaretrospectivecohortstudyofclinicalbiochemicalandradiologicaloutcomesinanondesignercentreatminimum15yearsfollowup AT johnfquinlan birminghamhipresurfacingaretrospectivecohortstudyofclinicalbiochemicalandradiologicaloutcomesinanondesignercentreatminimum15yearsfollowup |