Survival, Complications and Outcomes of the Birmingham Hip Resurfacing Compared to Cementless Total Hip Arthroplasty

Abstract

Aim: Metal-on-metal hip arthroplasty is developed to address specific complications experienced with the use of cementless hip arthroplasty. However, there is a lack of comparative studies. The aim of this study was to evaluate the survival, complications and functional outcome of the Birmingham Hip Resurfacing (BHR) and compare it to the cementless Omnifit hip prosthesis.

Materials and methods: We retrospectively compared a cohort BHR (n = 104) and Omnifit (n = 117) prostheses. Outcome measures included Oxford Hip Score (OHS), Hip disability and Osteoarthritis Outcome Score - Physical function Short Form (HOOS-PS) and EuroQol EQ-5D. Survival and complications were registered.

Results: Survival was 86% in the BHR group and 92% in the Omnifit group after six years follow-up. Survival distributions were not significantly different. Prognostic factor for revision in the BHR group was a smaller femoral component size. The BHR group had significantly better OHS, HOOS-PS and EQ-5D scores and less pain in rest and during weight bearing compared to the Omnifit group.

Conclusion: The BHR has significant better functional outcome and less pain than the Omnifit cohort, however, because of high revision rates and severe complications, general use is not recommended. Specific complications for the Omnifit femoral component are thigh pain and aseptic loosening, for which a revision offers a solution.