Bernard M. Diamond, M.D. - Hip Resurfacing

History of Hip Resurfacing
Who Is a Candidate for Hip Resurfacing?
Keep Your Bone
Restoring Anatomy
Better Loading
Future Options
Oxinium Technology for Hips

Now, young active patients who suffer from hip pain due to arthritis, dysplasia or avascular necrosis may benefit from the bone-conserving approach of the BIRMINGHAM HIP? Resurfacing System (BHR).

Unlike total hip replacement, the BHR hip resurfaces just a few centimeters of bone, preserving the natural shape, size and motion of your original joint. The BHR hip is not unlike a cap for a tooth.

Watch an animation that illustrates the differences between hip replacement and the BHR system.

Because this technologically advanced surgical procedure resurfaces rather than replaces the end of your femur (thighbone), you may participate in more strenuous physical activity with an implant that is potentially longer-lasting and more stable than total hip replacements.

The Birmingham Hip Resurfacing System was developed by doctors Derek McMinn and Ronan Treacy. It was first introduced in July 1997 in Birmingham, United Kingdom.

Including the United States, the Birmingham Hip Resurfacing System is being used in 27 countries. It has been implanted in more than 80,000 patients with a 98.4 % 10 year survivorship that has been confirmed in multiple publications.
There have been 14,000 BHR procedures done in the US since June of 2006 when the BHR received FDA approval.

The BIRMINGHAM HIP Resurfacing System has the longest clinical history of current generation resurfacing devices and is one of only 2 resurfacing devices approved by the US Food & Drug Administration.

Hip resurfacing is intended for young, active adults who are between the ages of 30 and 60 and in need of a hip replacement. Adults over 60 who are living active lifestyles and have good bone stock may also be considered for this procedure. Certain causes of hip arthritis can cause extreme deformity. These cases would probably not be good candidates for hip resurfacing.

Unlike Total Hip Replacement (THR), the Birmingham Hip Resurfacing procedure resurfaces the joint. A THR requires the removal of the femoral head and the insertion of a hip stem down the shaft of the femur as shown below.

In a hip resurfacing procedure the femoral head and femoral neck are preserved. During the procedure Dr. Diamond will only remove the worn cartilage and damaged first layer of bone and replaced with a low-wearing metal surface.

The shape of your hip determines how it moves and feels. In a total hip procedure Dr. Diamond spends a lot of time assessing the best device position to try and restore your normal anatomy. In the Birmingham Hip Procedure the head of the implant fits over the neck of your leg bone so it is in the right position for your hip ball and your anatomy is correct for you.

Even if you leg is now short due to arthritis the Birmingham Hip Head fits where your femoral head should be, often restoring leg length lost due to the degeneration of cartilage and bone. For patients with more severe anatomic changes Dr. Diamond can sometimes correct for anatomic issues with the Birmingham Hip System.

Bone gets denser when it is regularly loaded. If left unloaded the bone atrophies becoming less dense. Because a total hip replacement is fixed about a third of the way down from the top of the remaining leg bone, the upper part of the bone loses density over time. A Birmingham Hip loads the upper leg bone more like it is normally loaded resulting in maintaining bone density.

The Birmingham Hip leaves the option of a Total Hip Replacement for Later

Although failure of a Birmingham Hip is rare any joint replacement procedure includes some risks. Total hip replacement also has about the same rates of complications requiring a revision surgery. If a revision is required for a traditional total hip, removal is complicated and time consuming that then requires the implantation of a larger, often stiffer implant.

Because the Birmingham Hip Procedure spares bone, a standard total hip stem using Oxinium Technology for Hips could be used in a revision of a Birmingham Hip.

A common issue with hip replacements is what surgeons refer to as "wear." As the new surfaces of the implant rub together-up to 2 million times per year in active adults-friction occurs. This leads to scratches which make tiny fragments of plastic and metal material rub off, thus wearing down the implant.

This effect-not unlike the action of a fingernail file-is a main reason why knee implants can "fail," and why a patient may undergo repeat surgery years after the original procedure.

Smith & Nephew Orthopaedics, worked for more than a decade developing a new technology that addresses this problem for the tens of thousands of young, active patients who need a hip implant that can support their adventurous spirit. In 2003, OXINIUM? oxidized zirconium, an exclusive new material for hip replacements was introduced.

OXINIUM? material-a patented metal alloy and ceramic hybrid-has proven to be a superior metal for use in hip implants due to its hardness, smoothness and resistance to scratching and abrasion. The superior strength results in significantly less wear than cobalt chrome (historically the material of choice in hip implants).

Some facts that may interest you:

OXINIUM? material is 4,900 times more abrasion resistant than cobalt chrome, and may last longer than other implants as it reduces up to 98% of the implant wear common to cobalt chrome hips.

OXINIUM? material has the confident strength of a metal implant, but has the wear-reducing properties of a hard ceramic.

OXINIUM? material is 20% lighter than cobalt chrome