A medium-term comparison of hybrid hip replacement and Birmingham hip resurfacing in active young patients
Journal of Bone and Joint Surgery
... underwent BHR by the senior author, 54 (51 patients) were matched to patients who had undergone THA with regard to age, gender, body mass index and preoperative levels of activity. Radiologically, all hips were assessed for migration and osteolysis, THAs for polyethylene wear and BHRs for a pedestal sign. Patient reported outcomes, mortality and revision rates were compared. Results The mean follow-up of the patients with a hybrid THR was 19.9 years and for those with a BHR, 17.6 years. 13 patients with a hybrid THR and 5 with a BHR had died. The revision rate of the hybrid THRs was 14/54 and of the BHRs 6/54. Log rank comparison of Kaplan-Meier survival estimates demonstrated a significantly lower mortality in the BHR group (p=0.039; Hazard Ratio=0.37 (95% CI=0.15,0.95)) but a non-significant difference in revision rates (p=0.067; Hazard Ratio=0.43 (95% CI=0.18,1.06)). The BHRs recorded superior OHS (p=0.03), UCLA (p=0.0096), and EuroQol visual analogue scores (p=0.03). Significantly more BHRs had run, played sport and undertaken heavy manual labour in the month preceding follow up. Conclusion After 18 years, patients with BHRs reported superior patient reported outcome measures and remained more active with a lower mortality rate but no significant difference in revision rates. Both groups demonstrated progressive radiological changes at long-term follow-up.