According to a study, patients who had hip resurfacing surgery such as Birmingham Hip Resurfacing technique, had better quality of life, less pain and greater satisfaction a year after surgery when compared to those who had a total hip replacement. The study was presented at American Academy of Orthopedic Surgeons (AAOS) 2009 Annual Meeting.
The study led by Orthopedic surgeon Dr. Elizabeth Anne Lingard of Freeman Hospital in Newcastle Upon Tyne, England, was based on data collected from 214 total hip replacement patients and 132 hip resurfacing patients that was recorded in a joint registry maintained at a single surgeon’s practice from 2003-2006.
In the study, each patient had to undergo a questionnaire preoperatively and one year after surgery. The questionnaire included the Western Ontario and MacMaster Universities Osteoarthritis Index (referred to as WOMAC, it is a 24-item questionnaire that is completed by the patient and focuses on joint pain, stiffness and loss of function related to osteoarthritis of the knee and hip) and the SF-36 which is a self-report questionnaire completed by the patient that measures health-related quality of life (and generates 8 subscales: physical functioning, role limitations due to physical problems, bodily pain, general health perceptions, vitality, social functioning, role-limitations due to emotional problems, and mental health; and 2 summary scores: physical component and mental component). The patients also completed a questionnaire regarding satisfaction with their procedures and outcomes one year after surgery.
The study found that one year after surgery, patients in both group experienced significant improvements in WOMAC and SF-36. But the Hip-resurfacing patients had significantly higher WOMAC scores for decreased pain symptoms. Patient satisfaction was more in hip-resurfacing group and they reported that they were satisfied with their ability to perform functional activities after surgery.
“The (Birmingham) hip resurfacing technique allows me to preserve more of the patient’s natural bone structures and stability,” said Bradley Gerber, MD, Chief of Joint Replacement Surgery at South Nassau Communities Hospital. “I see hip resurfacing as the ideal solution for many of my younger, active patients who suffer from hip pain. As my patients are getting younger and younger, and are staying physically active much later in life, I’ve needed an alternative to total hip replacement that accommodates their age and lifestyle. Hip resurfacing is that alternative.”
In total hip replacement, the entire femoral head and neck is removed of, replacing it with a metal ball. Where as in BHR, the head and neck are untouched. Patient’s natural leg length is maintained using a artificial device during the resurfacing procedure.
The BHR is designed for patients suffering from hip pain due to osteoarthritis, hip dysplasia or avascular necrosis and for whom total hip replacement may not be appropriate due to an increased level of physical activity. Dr. Gerber, due to these reasons, suggests that the BHR is ideal for patients under age 60 who live non-sedentary lifestyles.
The BHR implant is similar to the size of a patient’s natural femoral head (hip ball). However, it is substantially larger than the femoral head of a traditional total hip replacement implant. This increased size ensures greater stability in the new joint, and it minimizes the risk of dislocation of the implant after surgery, which is a leading cause of implant failure after total hip replacement.