What is BIRMINGHAM HIP Resurfacing (BHR)?

The hip is a ball-and-socket joint. The BHR System is a conservative replacement of this joint, in that the bearing surfaces are made of metal. The BHR takes on the replacing of the surface of the femoral head (ball) and acetabulum (socket), but it preserves the bone inside the rest of the femur, including the neck. Its first implantation dates back to July 1997. It was approved by the Food and Drug Administration in the United States for use in 2006. Over 190,000 BHR implants have since been made since its introduction. In fact, BHR is the longest-serving hip resurfacing device.

Who is a good candidate for hip resurfacing?

Hip resurfacing is usually recommended for a young, fit, and energetic patient with hip osteoarthritis and strong, healthy bones. It is more often performed on men in their 50s. However, it is rarely done on people over 65. This depends on the patient and the type of resurfacing.

What is the procedure for hip resurfacing?

On the other hand, total hip replacement involves removing the natural femoral head and installing a hip stem down the shaft of the femur. Hip resurfacing still retains both the femoral head and the femoral neck.

He will excise only a few centimeters of bone around the femoral head, sculpting it to fit nicely within the BHR implant. Your surgeon will then prepare the acetabulum for the metal cup that will complete the ball-and-socket joint's socket aspect.

With the femoral component, it is merely positioned over the top of a prepared femoral head, resembling the placement of a tooth cap. The acetabular component is merely pressed into place, like a conventional hip replacement component.

What are the Advantages and Disadvantages of Hip Resurfacing?

Hip resurfacing may be indicated in young patients who maintain an active lifestyle. The surgery has its disadvantages, however, along with its potential advantages.

Advantages of Hip Resurfacing:

• There is less recovery time, and the patient needs shorter hospital stays and fewer weeks before normal activities can be resumed.
• The joint can withstand more strenuous activities, such as running better.
• It may last longer than the traditional hip replacement.
• The bigger ball is inherently more stable with less risk of dislocating.
• The procedure can help retain bone that can be used for revision at a later time should it become necessary.

Disadvantages of Hip Resurfacing:

• Medical effects of metal debris that might be introduced by a metal-on-metal prosthetic have not been documented.
• There is a slight risk of nerve impairment and resultant muscle weakness.
• It also bears a slight fracture risk, especially in the older women.
• It is much more complex than a normal hip replacement procedure, so finding an experienced surgeon may prove difficult.

What is the duration of Birmingham Hip Resurfacing surgery?

The surgery will take about 1.5 to 3 hours. After the surgery, you will spend one to four days in the hospital.

How long does Birmingham hip resurfacing last?

At least 10 and probably up to 15 years. A 2021 study reported that 92.9% of BHR joints remained well-functioning for at least 10 years. Another study reported that 97.4% of BHR joints remained good at 10 years, and 95.8% remained strong at 15 years.

How long, then, will one take to get back?

About six weeks after Birmingham Hip Resurfacing surgery, the patient will usually be able to do all the usual activities of daily life without pain. Sometimes, the surgeon may order physical therapy so as to help regain strength, range of motion and function in the hip.

What can I do to make the operation a success?

Here are some things that you can do to help prepare yourself for your operation

• Quit smoking: This reduces the risk of breathing complications, and your anesthetic is safer.
• Take paracetamol and ibuprofen if you can (available at home for use following discharge from the hospital) for postoperative pain relief.
• See your dentist: If you have loose teeth or crowns, treatment by your dentist can reduce the risks of damage to your teeth from any equipment used during anesthesia to support your breathing.
• Lose weight: If you are overweight, losing some of your weight will reduce most of the risks of anesthesia and surgery.
• Discuss your medical conditions: See your GP. If you have a long-term medical condition like diabetes, asthma or bronchitis, thyroid problems, heart problems, or high blood pressure (hypertension), discuss your medical conditions with your GP and bring any results.
• Do inform us if you are pregnant or breastfeeding, so we can plan your surgery accordingly.
• Know your usual medicines: Before you go into hospital, you will be advised which of your medicines you should continue taking and which you should stop. Make sure you take a full, current list of your medicines with you to all your appointments in the hospital and on admission.

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