Early clinical failure of the Birmingham metal-on-metal hip resurfacing is associated with metallosis and soft-tissue necrosis
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- B. Ollivere
- Institute of Orthopaedics
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- C. Darrah
- Institute of Orthopaedics
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- T. Barker
- Institute of Pathology, Norfolk & Norwich University Hospital, Colney Lane, Norwich, NR4 7UY, UK.
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- J. Nolan
- Institute of Orthopaedics
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- M. J. Porteous
- Department of Orthopaedics, West Suffolk Hospital, Hardwick Lane, Bury St Edmunds, Suffolk, IP33 2QZ, UK.
説明
<jats:p> 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). </jats:p><jats:p> 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. </jats:p><jats:p> 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. </jats:p>
収録刊行物
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- The Journal of Bone and Joint Surgery. British volume
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The Journal of Bone and Joint Surgery. British volume 91-B (8), 1025-1030, 2009-08
British Editorial Society of Bone & Joint Surgery