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Journal of Bone and Joint Surgery - British Volume, Vol 91-B, Issue 8, 1025-1030.
doi: 10.1302/0301-620X.91B8.21701  
Copyright © 2009 by British Editorial Society of Bone and Joint Surgery
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Early clinical failure of the Birmingham metal-on-metal hip resurfacing is associated with metallosis and soft-tissue necrosis

B. Ollivere, MRCS, Specialist Registrar1; C. Darrah, RGN, MSc, Nurse Research Manager1; T. Barker, FRCSPath, Histopathologist2; J. Nolan, FRCS, Consultant Orthopaedic Surgeon1; and M. J. Porteous, FRCS(Orth), Consultant Orthopaedic Surgeon3

1 Institute of Orthopaedics
2 Institute of Pathology, Norfolk & Norwich University Hospital, Colney Lane, Norwich, NR4 7UY, UK.
3 Department of Orthopaedics, West Suffolk Hospital, Hardwick Lane, Bury St Edmunds, Suffolk, IP33 2QZ, UK.

Correspondence should be sent to Dr B. Ollivere; e-mail: ben{at}ollivere.co.uk

The rate and mode of early failure in 463 Birmingham hip resurfacings in a two-centre, multisurgeon series were examined. Of the 463 patients two have died and three were lost to follow-up. The mean radiological and clinical follow-up was for 43 months (6 to 90).

We have revised 13 resurfacings (2.8%) including seven for pain, three for fracture, two for dislocation and another for sepsis. Of these, nine had macroscopic and histological evidence of metallosis. The survival at five years was 95.8% (95% confidence interval (CI) 94.1 to 96.8) for revision for all causes and 96.9% (95% CI 95.5 to 98.3) for metallosis.

The rate of metallosis related revision was 3.1% at five years. Risk factors for metallosis were female gender, a small femoral component, a high abduction angle and obesity. We do not advocate the use of the Birmingham Hip resurfacing procedure in patients with these risk factors.




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V. K. Eswaramoorthy, L. C. Biant, and R. E. Field
Clinical and radiological outcome of stemmed hip replacement after revision from metal-on-metal resurfacing
J Bone Joint Surg Br, November 1, 2009; 91-B(11): 1454 - 1458.
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Ceramic-on-metal bearings in total hip replacement: WHOLE BLOOD METAL ION LEVELS AND ANALYSIS OF RETRIEVED COMPONENTS
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eLetters:

Read all eLetters

Early clinical failure of the Birmingham hip
Henry W Hamilton, et al.
J Bone Joint Surg Br Online, 22 Sep 2009 [Full text]
Early clinical failure of the Birmingham hip not seen in South Devon
Mike Rodger, et al.
J Bone Joint Surg Br Online, 16 Nov 2009 [Full text]

(c) British Editorial Society of Bone and Joint Surgery All Rights Reserved
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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General