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Metal-on-metal hip resurfacing yields excellent results at 5-year follow-up

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NICE — Orthopaedic surgeons performing Birmingham hip resurfacing arthroplasty on a series of 117 hips revealed that the results compared favorably with those gleaned by the developers of the hip system in Birmingham, England.

“The results also show that resurfacing is well suited for younger, higher-demand patients,” said Giles Heilpern, FRCS, of London, who presented the findings at the 9th European Federation of National Associations of Orthopaedics and Traumatology Congress, here.

Heilpern reported 114 of 117 (97% follow-up) consecutive metal-on-metal hip resurfacings in 105 patients with a minimum of 5 years follow-up implanted between October 1999 and May 2002. Revision of either the femoral or acetabular component during the study period was defined as failure.

“We had four failures, giving us survivorship at 5 years of 97% (95% CI),” he said.

The mean follow-up was 72 months and the mean age at implantation was 54.5 years old. All patients were followed up clinically and radiographically, he said.

The mean Harris hip score at follow up was 96.4. The mean Oxford Hip Score fell from 41.6 preoperatively to 15.3 postoperatively (P<0.0001), and the UCLA Activity Scale rose from 3.93 preoperatively to 7.54 postoperatively (P<0.001), according to the abstract.

Radiographic analysis revealed an average stem shaft angle of 130.6° with average cup alignment of 36°. Neck thinning was present in 12 hips (10%).

“This study confirms that metal-on-metal resurfacing produces an excellent clinical and functional outcome in the younger patient who requires surgical intervention for hip disease,” he said. “It is also the first study with a minimum 5-year follow-up from outside the originating center.”

Moderator George Bentley, ChM, FRCS, of Middlesex, England, questioned why there was no control group for the trial, but noted that, “This is an excellent piece of work otherwise.”

For more information:

• Heilpern G, Shah N, Fordyce M. Birmingham hip resurfacing arthroplasty: a series of 117 consecutive hips with a minimum 5-year follow-up. Paper F224. Presented at the 9th European Federation of National Associations of Orthopaedics and Traumatology Congress. May 29-June 1, 2008. Nice.