REVIEW OF THE EARLY RESULTS OF BIRMINGHAM HIP RESURFACING ARTHROPLASTY IN A DISTRICT GENERAL HOSPITAL

Abstract

Abstract: resurfacing hip arthroplasty has shown promising early results in the treatment of hip arthrosis in younger patients as published from specialist centres in the United Kingdom. We are reporting early results and complications of Birmingham hip resurfacing arthroplasty (BHR) from a district general hospital.

This is a retrospective study of 216 hips in 186 patients during January 1999 to December 2004. The study included review of notes and X rays and a questionnaire based assessment of hip function and activities using Oxford Hip Score (OHS) and Duke’s activity score (DAS). This study has got national ethical committee approval.

The response rate for questionnaire was 76%. Average age was 53.3 years (range 20–72). Male: female ratio was 3:1. There were 152 unilateral and 32 bilateral cases. Majority of the cases had osteoarthritis in the hip. Average follow-up was 30.3 months (range 12–72). Average length of stay was 6 days (range 3–17). Average OHS and DAS were 15.8 and 51 respectively. 163 patients had OHS of less than 24. 113 patients had DAS of 58.2.

Radiological assessment showed six cases of hetero-topic calcification. Lysis was noted at prosthesis-neck junction in two cases but patients were asymptomatic.

The complications included superficial wound infection in 2, DVT in 6, neuroparaxia of sciatic and brachial plexus in one case each. There were six dislocations. There were nine revisions – seven following fracture neck of femur and two for aseptic loosening. The incidence of fracture neck of the femur was high in early part of the study suggesting technical improvement with experience.

Overall failure was 4.1%, slightly higher than other published literature. The OHS and DAS were comparable to other published results.

In conclusion the results of the BHR are encouraging and long-term prospective study is needed to find out the longevity of the implants and long-term results.