@dapplega Here is the latest from the Aussie Joint Registry:
As you can see from the above data taken directly from the 2020 report, as of 2019... 15.2% of all people that got hip resurfacing at 19 years had a revision. For the THR, it is 12.2% at 19 years. To most people, it would seem from this data that resurfacing is worse compared to THR. But here is where you have to analyze the data carefully, because the above information is not factoring in a lot of variables. Over the last 19 years, there were many types of hip resurfacing implants... and virtually all of them were recalled within the last 10 years...except the BHR. So there is 10 years of data from bad devices in the early years negatively affecting the revision rate of hip resurfacing. (Yes... this would be the case to some degree with total hip implants... but the affect would not be as dramatic).
Another key variable is that people with hip resurfacing are younger and more active. That is why they get hip resurfacing. A better comparison would be to separate the data so that the same age range is compared. (I used to have that data somewhere). When you compare apples to apples, hip resurfacing has a lower revision rate. Perhaps the biggest variable in the data is that 19 years ago, many hip surgeons were just learning how to do hip resurfacing. Whereas the THR is definitely taught in med school for all hip surgeons, but not putting in a BHR. And finally, the most important variable is surgeon experience. If you look at the data from Dr. Su, Gross, Pritchett, Brooks, (obviously McMinn) and other high volume hip resurfacing surgeons, their revision rates are exceeding low and much better than the THR revision rate... where EVERY THR surgeon is pretty much a high volume surgeon.
I should point out that another key consideration is that the re-revision rate (which means getting a 2nd revision - or 3rd overall hip implant) is much lower for BHR patients who get a first THR.
If you have to revise a BHR, a THR performed at the time of the 1st revision has the lowest cumulative percent 2nd revision of 15.5% at 10 years... whereas the 2nd revision rate for the THR (thus... THR original to THR 1st revision to THR 2nd revision) is 27%... nearly 12 percent higher. Gary