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Birmingham Hip Resurfacing

Matti Seppänen, Mikko Karvonen, Petri Virolainen, Ville Remes, Pekka Pulkkinen, Antti Eskelinen, Antti Liukas, Keijo T Mäkelä
Background and purpose - In a previous registry report, short-term implant survival of hip resurfacing arthroplasty (HRA) in Finland was found to be comparable to that of total hip arthroplasty (THA). Since then, it has become evident that adverse reactions to metal debris (ARMDs) may also be associated with HRA, not only with large-diameter head metal-on-metal THA. The aim of the study was to assess medium- to long-term survivorship of HRA based on the Finnish Arthroplasty Register (FAR). Patients and methods - 5,068 HRAs performed during the period 2001-2013 in Finland were included...
October 19, 2016: Acta Orthopaedica
Jason J Howard
Due to problems with wear particle generation and subsequent loosening using conventional metal-on-polyethylene total hip replacements, there has been a shift toward alternative bearing systems, including metal-on-metal (MoM), for younger, more active patients with degenerative joint disease. Based on positive results from early short-term clinical studies, MoM hip replacements were readily adopted by orthopedic surgeons with thousands being implanted worldwide over the past decade. Unacceptably high revision rates reported by two national joint registries called into question the rigorousness of the regulatory approval process for these implants, particularly with respect to premarket data requirements to prove safety, effectiveness, and the appropriateness of the regulatory pathway chosen...
2016: Medical Devices: Evidence and Research
Gulraj S Matharu, Fiona Berryman, Lesley Brash, Paul B Pynsent, Ronan B C Treacy, David J Dunlop
BACKGROUND: We investigated whether blood metal ions could effectively identify patients with metal-on-metal hip implants with two common designs (Birmingham Hip Resurfacing [BHR] and Corail-Pinnacle) who were at risk of adverse reactions to metal debris. METHODS: This single-center, prospective study involved 598 patients with unilateral hip implants (309 patients with the BHR implant and 289 patients with the Corail-Pinnacle implant) undergoing whole blood metal ion sampling at a mean time of 6...
April 20, 2016: Journal of Bone and Joint Surgery. American Volume
Satish V Dhotare, Deepak G Shivarathre, Cristina Croitoru, Catherine Armstrong, Birender Kapoor, Viju K Peter
PURPOSE: The main aim of our study is to report the medium-term survivorship of Birmingham Hip Resurfacing (BHR) cup and a large modular metal head (MMT) on an uncemented Freeman femoral stem. No results have been reported till date with these implants combinations. METHODS: A total of 205 metal-on-metal total hip replacements (MoM THRs) were performed on 190 patients from October 2002 to November 2004. Prior to the Medicines and Healthcare Products Regulatory Agency (MHRA) guidelines, the patients were followed up at 3, 6 and 12 months postoperatively and annually thereafter...
May 16, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Samuel Barke, Francesc Malagelada, Giles Stafford, Derek McMinn, Richard Field
We have investigated whether patient reported outcomes provided by patients with Birmingham Hip Resurfacing (BHR) changed after negative media coverage of metal-on-metal (MOM) hip replacement. We also investigated whether patients whose procedures were performed by a designer surgeon behaved differently to those performed elsewhere. 1178 consecutive BHR procedures performed between January 2002 and December 2006, by one of the designer surgeons in his private practice, were reviewed. We also reviewed 402 BHRs undertaken by two non-designer surgeons in both their NHS and private practice...
March 2016: Acta Orthopaedica Belgica
Lisa Renner, Martin Faschingbauer, Tom Schmidt-Braekling, Friedrich Boettner
INTRODUCTION: Metal-on-metal (MoM) bearings are known to release metal ions secondary to wear and corrosion. This may cause local reactions (adverse soft tissue reactions and osteolysis) and systemic effects. Little is known about the exact pattern and the differences between large head MoM total hip replacements (THA) and resurfacings (HR). QUESTIONS: (1) Is there a difference in metal ion concentrations between HR and MoM-THR using the same bearing design (Birmingham Hip Resurfacing System, Smith & Nephew, Inc...
May 2016: Archives of Orthopaedic and Trauma Surgery
Cecilia Pascual-Garrido, Brandon L Morris, Michael R Dayton
This study reported the outcomes of patients treated with the Birmingham Hip Resurfacing System (Smith & Nephew, Memphis, Tennessee) to identify the prevalence of complications and failures. A retrospective review of 202 patients (206 hips) was performed. Outcomes were assessed clinically with Harris Hip Score at 6 and 12 months and then yearly. Subanalysis was performed, with the hips divided according to patient sex and size of the femoral component. Mean patient age was 51±8 years, and mean follow-up was 4±1...
March 2016: Orthopedics
Nemandra Sandiford, S K Muirhead-Allwood, J A Skinner
BACKGROUND: Hip resurfacing arthroplasty (HRA) is primarily indicated for young, active patients with disabling coxarthrosis who wish to remain active and return to sports after surgery. Relatively few prospective studies have assessed return to sporting activity and impact of gender and age on this. MATERIALS AND METHODS: Seventy-nine consecutive patients treated with HRA were included. Patients were reviewed clinically and radiologically. Function was assessed using the modified University of California Los Angeles (UCLA) activity score...
November 2015: Indian Journal of Orthopaedics
P J Brooks
Hip resurfacing has been proposed as an alternative to traditional total hip arthroplasty in young, active patients. Much has been learned following the introduction of metal-on-metal resurfacing devices in the 1990s. The triad of a well-designed device, implanted accurately, in the correct patient has never been more critical than with these implants. Following Food and Drug Administration approval in 2006, we studied the safety and effectiveness of one hip resurfacing device (Birmingham Hip Resurfacing) at our hospital in a large, single-surgeon series...
January 2016: Bone & Joint Journal
Adeel Aqil, Hassaan Q Sheikh, Milad Masjedi, Jonathan Jeffers, Justin Cobb
Total hip arthroplasty in the young leads to difficult choices in implant selection. Until recently bone conserving options were not available for younger patients with deficient femoral head bone stock. The novel Birmingham Mid-Head Resection (BMHR) device offers the option of bone conserving arthroplasty in spite of deficient femoral head bone stock. Femoral neck fracture is a known complication of standard resurfacing arthroplasty and is the most common reason for revision. It is unknown whether this remains to be the case for the BMHR neck preserving implants...
September 2015: Clinics in Orthopedic Surgery
Denis Nam, Ryan M Nunley, Erin L Ruh, C Anderson Engh, John S Rogerson, Peter J Brooks, Stephen J Raterman, Edwin P Su, Robert L Barrack
Previous data on the survivorship of the Birmingham Hip Resurfacing (BHR) implant have come from design surgeons and large national databases outside of the United States, and there is a lack of reported outcomes of surface replacement arthroplasty from US centers. A retrospective study was undertaken of 1271 hips treated with a BHR system (Smith & Nephew, Memphis, Tennessee) between June 2006 and September 2008 at 6 high-volume total joint centers in the United States. Demographic features, Harris Hip Score (HHS), and radiographic findings were recorded...
August 2015: Orthopedics
Gulraj S Matharu, Fiona Berryman, Lesley Brash, Paul B Pynsent, Ronan B C Treacy, David J Dunlop
PURPOSE: To determine whether gender, femoral head size, acetabular inclination, and time since surgery predicted high blood metal ion concentrations following Birmingham Hip Resurfacing (BHR). METHODS: BHR patients with unilateral bearings at one specialist centre with blood cobalt and chromium concentrations measured up to May 2013 were included. This comprised a mixed (at-risk) group including symptomatic patients and asymptomatic individuals with specific clinical and/or radiological findings...
November 2015: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Lisa Renner, Martin Faschingbauer, Friedrich Boettner
INTRODUCTION: Previous studies showed poor outcomes for patients undergoing revision of failed metal-on-metal total hip arthroplasty (MoM-THA) and resurfacing (RS) with an increased risk of dislocation. Dual mobility inserts are an option to retain the acetabular component and change the metal-on-metal bearing to plastic-on-metal. The current study analyzes the rationale for the off-label use of a dual mobility poly insert (MDM X3, Stryker, Mahwah, NJ) in a Birmingham metal shell (Smith & Nephew, Memphis, TN)...
August 2015: Archives of Orthopaedic and Trauma Surgery
Asaad Asaad, Alister Hart, Michael M Y Khoo, Kevin Ilo, Gavin Schaller, Jonathan D J Black, Sarah Muirhead-Allwood
BACKGROUND: Mid-head resection total hip resurfacing arthroplasty was promoted as an alternative to traditional total hip resurfacing for patients with poor femoral head bone quality or abnormal femoral head morphology, because those patients are at high risk of failure with traditional total hip resurfacing. It is a large-headed metal-on-metal device that uses a short, bone-conserving stem. Good performance of the implant has been reported at short-term followup, but no information on the implant performance in the mid- or long-term is available...
December 2015: Clinical Orthopaedics and related Research
Samik Banerjee, Timothy Little, Nicholas Little
OBJECTIVE: To report a case of a peri-prosthetic hip fracture fixed using a previously unreported technique of intramedullary nailing with dual proximal fixation. CASE SUMMARY: An 81-year-old nursing home resident suffered a multi-fragmentary peri-prosthetic hip fracture around a Birmingham Hip Resurfacing arthroplasty (BHR), which was fixed using a novel technique. DISCUSSION: Such fractures pose a significant surgical dilemma with regards to the optimal method of treatment...
June 2015: Journal of Orthopaedics
Md Quamar Azam, Stephen McMahon, Gabrielle Hawdon, Sukesh Rao Sankineani
INTRODUCTION: Resurfacing as a percentage of total hip arthroplasty rose from 5.6 % in 2001 to 8.9 % in 2005 in Australia. During the same period the resurfacing to conventional prosthesis rose from 19.6 % 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...
January 2016: International Orthopaedics
Akshay Mehra, Fiona Berryman, Gulraj S Matharu, Paul B Pynsent, Eric S Isbister
We report outcomes on 120 Birmingham Hip Resurfacings (BHRs) (mean age 50 years) at a minimum of ten-years follow-up. Cases were performed by one surgeon and included his learning curve. Six hips were revised, with no revisions for infection, dislocation, or adverse reaction to metal debris. Ten-year survival was 94.2% (95% confidence interval (CI) 88.8%-98.7%) for all revisions and 96.1% (95% CI 91.5%-99.8%) for revisions for aseptic loosening. Gender (P = 0.463) and head size (P = 0.114) did not affect revision risk...
July 2015: Journal of Arthroplasty
Gulraj S Matharu, Hemant G Pandit, David W Murray, Ronan B C Treacy
PURPOSE: The purpose of this review was to assess the ten to 15-year outcomes of metal-on-metal hip resurfacing (MoM HR) when performed at designing and independent centres, and make recommendations for the future use of MoM HR. METHODS: Studies reporting ten to 15-year outcomes for modern MoM HR devices from both designing and independent centres were reviewed. Outcomes from these studies were assessed to allow the formulation of recommendations for the future use of MoM HR...
October 2015: International Orthopaedics
Mika Junnila, Matti Seppänen, Jari Mokka, Petri Virolainen, Tuukka Pölönen, Tero Vahlberg, Kimmo Mattila, Esa K J Tuominen, Juho Rantakokko, Ville Äärimaa, Ari Itälä, Keijo T Mäkelä
BACKGROUND AND PURPOSE: Concern has emerged about local soft-tissue reactions after hip resurfacing arthroplasty (HRA). The Birmingham Hip Resurfacing (BHR) was the most commonly used HRA device at our institution. We assessed the prevalence and risk factors for adverse reaction to metal debris (ARMD) with this device. PATIENTS AND METHODS: From 2003 to 2011, BHR was the most commonly used HRA device at our institution, with 249 implantations. We included 32 patients (24 of them men) who were operated with a BHR HRA during the period April 2004 to March 2007 (42 hips; 31 in men)...
June 2015: Acta Orthopaedica
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