ORLANDO, Fla. — The success of hip resurfacing depends on the use of a well-designed device and good technique for properly selected patients, according to a presenter here.
“Resurfacing is very attractive to patients, less attractive to surgeons because there are many ways to get into trouble. If you do it, if you do the deep dive, you will become a better hip surgeon,” Peter J. Brooks, MD, FRCS(C), said at the Current Concepts in Joint Replacement Winter Meeting.
Brooks said in the mid-term results of study of more than 2,200 patients implanted with the Birmingham Hip, there were few complications with no dislocations or femoral loosening seen. More than 90% of the patients were diagnosed with osteoarthritis, and femoroacetabular impingement was the predominant pathology. Average patient age was 53 years, and 72% of the patients were male. Overall, 1,500 patients had a minimum follow-up of 2 years.
The researchers performed all of the hip resurfacing with an anterolateral approach. The average component head size was 51 mm for males and 45 mm for females.
Peter J. Brooks
Brooks said one patient had socket loosening, one patient had head collapse, two patients had femoral neck fractures and two patients had deep infections. Two patients had metallosis due to either component malposition or being a small, dysplastic female. There were no pseudotumors.
Overall survivorship at up to 8 years was more than 99%, he said. For the male patients with osteoarthritis who were younger than 50 years, survivorship was 100%.
Brooks advised that surgeons worry about small-sized patients and femoral anteversion. He also recommended additional imaging for selected patients, including a standing lateral pelvis radiograph and CT scans for femoral anteversion, to help with the patient-selection process. Additionally, the use of mushroom templates can help a surgeon pick the correct head size, as patients have different head-neck ratios, he said. — by Kristine Houck, MA, ELS
Brooks PJ. Paper #12. Presented at: Current Concepts in Joint Replacement Winter Meeting. Dec. 10-13, 2014; Orlando, Fla.
Disclosure: Brooks receives consulting fees from Smith & Nephew and Stryker.