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This is where the worn surface of the hip joint (most often the result of Osteoarthritis) is removed. The amount of bone removed is usually very small and is replaced with a metal-on-metal lining, which is covered by a substance called Hydroxyapatite to help secure the prostheses in place. This is called the Birmingham Hip Resurfacing (BHR).
An incision is made into the buttock and access is gained to the hip joint. The prosthesis chosen is the one closest possible to the normal size of the hip (small people have small joints and large people have large joints, as you would expect). Great care is taken to keep the wound as small and as neat as possible.
Birmingham Hip Resurfacing or Surface Replacement Arthroplasty is a bone-conserving alternative to conventional Total Hip Replacement (THR). Unlike Total Hip Replacement, Birmingham hip Resurfacing does not involve the removal of the femoral head and neck nor removal of bone from the femur. Rather, the head, neck and femur bone is preserved in an effort to facilitate future surgery should it be necessary and to enable the patient to take advantage of newer technology or treatments in the future. The current generation of hip Resurfacing devices utilize a metal bearings have demonstrated a much higher level of wear resistance as well as reduced bone loss and inflammatory tissue reaction about the hip joint as compared to metal-polyethylene bearings.
Unlike a total hip replacement (THR), the BIRMINGHAM HIP resurfaces the joint. The worn cartilage and damaged first layer of bone are removed and a fresh, low-wearing metal surface is installed. Total hip replacements require the removal of the upper segment of bone, the hollowing out of the upper half of the leg bone, and a large spike fixed to this upper bone, replacing the top part of the femur.
There are a few major concerns with hip resurfacing surgery, and unfortunately, no one knows the long-term results of the implants that are currently being used. Therefore, no one can definitavely say that this surgery is better or wosre than a standard hip replacement. The current implants used in hip resurfacing have only been used for about 10 years, and the only data available is on so-called short-term (less than 1 year) and mid-term (1 to 10 years) follow-up. No long-term data are available for hip resurfacing surgery.
here are several reasons for a patient to require hip or knee surgery, and with the latest advances in Replacement, Resurfacing and Arthroscopy technology, these procedures can be completed in operations that usually take between 1 and 2 hours, with patients expecting a stay in hospital of 7 days or less (depending on age and general fitness).
Hip resurfacing surgery is an alternative to standard hip replacements for patients with severe arthritis. In hip resurfacing surgery, the implant is smaller, and less normal bone is removed. Hip resurfacing is gaining interest, especially in younger patients.
Why is hip resurfacing surgery performed ?
Hip resurfacing is a treatment for : -
Osteoarthritis
Developmental Dysplasia of the Hip
Avascular Necrosis (AVN)
Inflammatory Arthritis (rheumatoid arthritis)
Who can benefit from having Birmingham hip resurfacing surgery ?
Birmingham hip resurfacing surgery is usually seen as an earlier alternative to THR. Ideal candidates are individuals who are active and under the age of 60-65, with strong bone around the hip joint. Surgeons are not keen to perform total hip replacement at an early age, as this will most likely result in additional replacements later on. Individuals who suffer from certain medical conditions, for example arthritis, may only be suitable for the total hip replacement surgery.
The BHR advantage
Traditional Total Hip Replacements (THR), invariably have a 'metal on plastic' bearing. These are reasonably successful in elderly relatively inactive patients, but offer unacceptably poor long term outcomes for young, active patients often with unavoidable multiple revision surgeries and associated complications. It is to avoid this unfortunate sequence of events that Birmingham Hip Resurfacing (BHR) was developed.
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