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Resurfacing for hips: March 2012 report on HR in women advised against

Josephine

NURSE DIRECTOR EMERITUS
Nurse Director
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March 2012 from the British Journal of Bone and Joint Surgery would appear to indicate caution when planning to carry out Birmingham Hip Resurfacing device in women:

Birmingham hip resurfacing at a mean of ten years
Results from an independent centre


Synopsis:
independent review of 230 consecutive Birmingham hip resurfacings (BHRs) in 213 patients (230 hips) at a mean follow-up of 10.4 years.

The (implant) survival rate for the whole cohort was 94.5%.
The (implant) survival rate in women was 89.1% and in men was 97.5%.
Women were 1.4 times more likely to suffer (implant) failure than men.

For each mm increase in component size there was a 19% lower chance of a failure.
- mean Oxford hip score was 45.0 (median 47.0, 28 to 48);
- mean UCLA activity score was 7.4 (median 8.0, 3 to 9);
- mean patient satisfaction score was 1.4 (median 1.0, 0 to 9).

- a total of 8 hips had lysis in the femoral neck and 2 hips had acetabular lysis.
- 1 hip had progressive radiological changes around the peg of the femoral component.
- there was no evidence of progressive neck narrowing between five and ten years.

Our results confirm that BHR provides good functional outcome and durability for men, at a mean follow-up of ten years.
We are now reluctant to undertake hip resurfacing in women with this implant.
 

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