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Clinical Orthopaedics and Related Research

, Volume 466, Issue 4, pp 920–926 | Cite as

The Influence of Surgical Approach on Outcome in Birmingham Hip Resurfacing

  • Callum W. McBrydeEmail author
  • Matthew P. Revell
  • Andrew M. Thomas
  • Ronan B. Treacy
  • Paul B. Pynsent
Original Article Hip

Abstract

Various approaches have been described for metal-on-metal hip resurfacing. We compared the posterolateral and direct lateral approaches for complications, pain, function, and implant survival in the short and medium term for two surgeons in a consecutive series of 790 patients (909 hips; July 1997 to July 2004) followed until July 2007. The direct lateral approach group included 135 resurfacing procedures and the posterolateral group included 774 procedures. There was no difference between the two groups for age or gender. The minimum followup for the anterolateral group was 2 years (mean, 5.1 years; range, 2.0–9.4 years) and for the posterolateral group 2 years (mean, 5.5 years; range, 2.0–9.6 years). There were no differences between the two approaches for complications, additional surgery, implant survival, or Oxford hip scores. The 8-year survival rate was 97.9% (95% confidence interval, 89.9–100) for the direct lateral approach and 97.2% (95% confidence interval, 93.9–99.3) for the posterolateral approach. This study indicates both approaches offer excellent pain reduction and return to function after Birmingham hip resurfacing with no difference in survival or in the incidence of complications. An 8-year survival rate of 97% can be achieved using either the posterolateral approach or the direct lateral approach.

Level of Evidence: Level III, therapeutic study. See the Guidelines for authors for a complete description of levels of evidence.

Keywords

Femoral Head Femoral Component Femoral Neck Fracture Acetabular Component Posterolateral Approach 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

We thank the staff of the Research and Teaching Centre at the Royal Orthopaedic Hospital, Birmingham, for support in the production of this research.

References

  1. 1.
    Amstutz HC, Beaulé PE, Dorey FJ, Le Duff MJ, Campbell PA, Gruen TA. Metal-on-metal hybrid surface arthroplasty: two to six-year follow-up study. J Bone Joint Surg Am. 2004;86:28–39.PubMedGoogle Scholar
  2. 2.
    Beaulé PE, Campbell P, Shim P. Femoral head blood flow during hip resurfacing. Clin Orthop Relat Res. 2007;456:148–152.PubMedCrossRefGoogle Scholar
  3. 3.
    Daniel J, Pynsent PB, McMinn DJ. Metal-on-metal resurfacing of the hip in patients under the age of 55 years with osteoarthritis. J Bone Joint Surg Br. 2004;86:177–184.PubMedCrossRefGoogle Scholar
  4. 4.
    Dawson J, Fitzpatrick R, Carr A, Murray D. Questionnaire on the perceptions of patients about total hip replacement. J Bone Joint Surg Br. 1996;78:185–190.PubMedGoogle Scholar
  5. 5.
    Forrest N, Welch A, Murray AD, Schweiger L, Hutchison J, Ashcroft GP. Femoral head viability after Birmingham resurfacing hip arthroplasty: assessment with use of [18F] fluoride positron emission tomography. J Bone Joint Surg Am. 2006;88(suppl 3):84–89.PubMedCrossRefGoogle Scholar
  6. 6.
    Freeman MA. Some anatomical and mechanical considerations relevant to the surface replacement of the femoral head. Clin Orthop Relat Res. 1978;134:19–24.PubMedGoogle Scholar
  7. 7.
    Ganz R, Gill TJ, Gautier E, Ganz K, Krügel N, Berlemann U. Surgical dislocation of the adult hip a technique with full access to the femoral head and acetabulum without the risk of avascular necrosis. J Bone Joint Surg Br. 2001;83:1119–1124.PubMedCrossRefGoogle Scholar
  8. 8.
    Gautier E, Ganz K, Krügel N, Gill T, Ganz R. Anatomy of the medial femoral circumflex artery and its surgical implications. J Bone Joint Surg Br. 2000;82:679–683.PubMedCrossRefGoogle Scholar
  9. 9.
    Hardinge K. The direct lateral approach to the hip. J Bone Joint Surg Br. 1982;64:17–19.PubMedGoogle Scholar
  10. 10.
    Katz JN, Losina E, Barrett J, Phillips CB, Mahomed NN, Lew RA, Guadagnoli E, Harris WH, Poss R, Baron JA. Association between hospital and surgeon procedure volume and outcomes of total hip replacement in the United States Medicare population. J Bone Joint Surg Am. 2001;83:1622–1629.PubMedCrossRefGoogle Scholar
  11. 11.
    Kawaguchi Y, Matsui H, Tsuji H. Back muscle injury after posterior lumbar spine surgery: a histologic and enzymatic analysis. Spine. 1996;21:941–944.PubMedCrossRefGoogle Scholar
  12. 12.
    Khan A, Yates P, Lovering A, Bannister GC, Spencer RF. The effect of surgical approach on blood flow to the femoral head during resurfacing. J Bone Joint Surg Br. 2007;89:21–25.PubMedCrossRefGoogle Scholar
  13. 13.
    Kim WY, Muddu BN. Eleven-year results of the ABG I hip replacement. Int Orthop. 30:182–184.Google Scholar
  14. 14.
    Kwon MS, Kuskowski M, Mulhall KJ, Macaulay W, Brown TE, Saleh KJ. Does surgical approach affect total hip arthroplasty dislocation rates? Clin Orthop Relat Res. 2006;447:34–38.PubMedCrossRefGoogle Scholar
  15. 15.
    McMinn DJ, Daniel J, Pynsent PB, Pradhan C. Mini-incision resurfacing arthroplasty of hip through the posterior approach. Clin Orthop Relat Res. 2005;441:91–98.PubMedCrossRefGoogle Scholar
  16. 16.
    Minns RJ, Crawford RJ, Porter ML, Hardinge K. Muscle strength following total hip arthroplasty: a comparison of trochanteric osteotomy and the direct lateral approach. J Arthroplasty. 1993;8:625–627.PubMedCrossRefGoogle Scholar
  17. 17.
    Mont MA, Ragland PS, Marker D. Resurfacing hip arthroplasty: comparison of a minimally invasive versus standard approach. Clin Orthop Relat Res. 2005;441:125–131.PubMedCrossRefGoogle Scholar
  18. 18.
    NJR Steering Committee. National Joint Registry for England and Wales 3rd Annual Clinical Report. The NJR Centre, Hemel Hempstead, UK, February 2006. Available at: http://www.njrcentre.org.uk/documents/reports/annual/3rd/NJR_AR2_LR.pdf. Accessed July 2007.
  19. 19.
    Nork SE, Schär M, Pfander G, Beck M, Djonov V, Ganz R, Leunig M. Anatomic considerations for the choice of surgical approach for hip resurfacing arthroplasty. Orthop Clin North Am. 2005;36:163–170, viii.PubMedCrossRefGoogle Scholar
  20. 20.
    Nötzli HP, Siebenrock KA, Hempfing A, Ramseier LE, Ganz R. Perfusion of the femoral head during surgical dislocation of the hip: monitoring by laser Doppler flowmetry. J Bone Joint Surg Br. 2002;84:300–304.PubMedCrossRefGoogle Scholar
  21. 21.
    Pollard TC, Baker RP, Eastaugh-Waring SJ, Bannister GC. Treatment of the young active patient with osteoarthritis of the hip: a five- to seven-year comparison of hybrid total hip arthroplasty and metal-on-metal resurfacing. J Bone Joint Surg Br. 2006;88:592–600.PubMedCrossRefGoogle Scholar
  22. 22.
    Pynsent PB, Adams DJ, Disney SP. The Oxford hip and knee outcome questionnaires for arthroplasty. J Bone Joint Surg Br. 2005;87:241–248. Errata. J Bone Joint Surg Br. 2005;87:1166.Google Scholar
  23. 23.
    R Development Core Team. R: A Language and Environment for Statistical Computing. Vienna, Austria: R Foundation for Statistical Computing; 2006.Google Scholar
  24. 24.
    Revell MP, McBryde CW, Bhatnagar S, Pynsent PB, Treacy RBC. Metal-on-metal hip resurfacing in osteonecrosis of the femoral head. J Bone Joint Surg Am. 2006;88(suppl 3):98–103.PubMedCrossRefGoogle Scholar
  25. 25.
    Steffen RT, Smith SR, Urban JPG, McLardy-Smith P, Beard DJ, Gill HS, Murray DW. The effect of hip resurfacing on oxygen concentration in the femoral head. J Bone Joint Surg Br. 2005;87:1468–1474.PubMedCrossRefGoogle Scholar
  26. 26.
    Stephenson PK, Freeman MA. Exposure of the hip using a modified anterolateral approach. J Arthroplasty. 1991;6:137–145.PubMedCrossRefGoogle Scholar
  27. 27.
    Sugamoto K, Ochi T, Takahashi Y, Tamura T, Matsuoka T. Hemodynamic measurement in the femoral head using laser Doppler. Clin Orthop Relat Res. 1998;353:138–147.PubMedCrossRefGoogle Scholar
  28. 28.
    Treacy RBC, McBryde CW, Pynsent PB. Birmingham hip resurfacing arthroplasty: a minimum follow-up of five years. J Bone Joint Surg Br. 2005;87:167–170.PubMedCrossRefGoogle Scholar
  29. 29.
    Whiteside LA, Lange DR, Capello WR, Fraser B. The effects of surgical procedures on the blood supply to the femoral head. J Bone Joint Surg Am. 1983;65:1127–1133.PubMedGoogle Scholar

Copyright information

© The Association of Bone and Joint Surgeons 2008

Authors and Affiliations

  • Callum W. McBryde
    • 1
    Email author
  • Matthew P. Revell
    • 1
  • Andrew M. Thomas
    • 1
  • Ronan B. Treacy
    • 1
  • Paul B. Pynsent
    • 1
  1. 1.Research and Teaching CentreRoyal Orthopaedic HospitalNorthfieldUK

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