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Journal of Bone and Joint Surgery - British Volume, Vol 88-B, Issue 8, 1110-1115.
doi: 10.1302/0301-620X.88B8.17567  
Copyright © 2006 by British Editorial Society of Bone and Joint Surgery
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Biomechanics of the Birmingham hip resurfacing arthroplasty

K. L. Ong, PhD, Managing Engineer1; S. M. Kurtz, PhD, Principal Engineer1; M. T. Manley, PhD, Bioengineer Consultant2; N. Rushton, MD, FRCS, Professor of Orthopaedics3; N. A. Mohammed, MBBS, Research Fellow4; and R. E. Field, PhD, FRCS, FRCS(Orth), Consultant Orthopaedic Surgeon4

1 Exponent Incorporated, 3401 Market Street, Suite 300, Philadelphia, Pennsylvania 19104, USA. (also affiliated to the School of Biomedical Engineering Science and Health Systems, Drexel University, Philadelphia, Pennsylvania 19104, USA).
2 Stryker Orthopedics, 24 Shinnecock Trail, Franklin Lakes, New Jersey 07417, USA.
3 Orthopaedic Research Unit University of Cambridge, Box 180, Addenbrooke’s Hospital, Cambridge CB2 2QQ, UK.
4 South West London Elective Orthopaedic Centre, Dorking Road, Epsom, Surrey KT18 7EG, UK.

Correspondence should be sent to Dr K. Ong; e-mail: kong{at}exponent.com

The effects of the method of fixation and interface conditions on the biomechanics of the femoral component of the Birmingham hip resurfacing arthroplasty were examined using a highly detailed three-dimensional computer model of the hip. Stresses and strains in the proximal femur were compared for the natural femur and for the femur resurfaced with the Birmingham hip resurfacing. A comparison of cemented versus uncemented fixation showed no advantage of either with regard to bone loading. When the Birmingham hip resurfacing femoral component was fixed to bone, proximal femoral stresses and strains were non-physiological. Bone resorption was predicted in the inferomedial and superolateral bone within the Birmingham hip resurfacing shell. Resorption was limited to the superolateral region when the stem was not fixed. The increased bone strain observed adjacent to the distal stem should stimulate an increase in bone density at that location. The remodelling of bone seen during revision of failed Birmingham hip resurfacing implants appears to be consistent with the predictions of our finite element analysis.




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Registered charity no: 209299     Print ISSN: 0301-620X
Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General