Fong Scott, Shah Aakash K, Hecht Christian J, Kamath Atul F
Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, OH, 44195, USA.
J Orthop. 2024 Apr 16;55:134-148. doi: 10.1016/j.jor.2024.04.016. eCollection 2024 Sep.
When indicated, Birmingham Hip Resurfacing (BHR) presents a viable alternative to total hip arthroplasty (THA), but there remain questions about the long-term outcomes of BHR. Therefore, we asked: 1) what are the long-term patient-reported outcomes and 2) survivorship rates following BHR; 3) what are the causes for revision surgery after BHR? and 4) how have these outcomes compared to THA at long-term follow-up.
A query of PubMed, MEDLINE, Scopus, and Cochrane in September 2023 was performed. Articles were included if they reported BHR survivorship rates at ≥10 years. Survivorship was defined as an all-cause revision of any BHR component. This review encompasses 26 articles, totaling 13,103 hips. Mean follow-up ranged from 6.0 to 20.9 years, but each study had at least a subgroup analysis for ≥10-year follow-up.
Five studies compared preoperative and postoperative PROs for BHR, with four reporting improvement in at least one PRO after 10-year follow-up. Overall, survivorship rates ranged from 83% to 100% across diverse long-term timeframes, with 25 of 26 studies reporting 10-year survivorship rates greater than 87%. The primary reasons for revisions were implant loosening (22%), adverse reactions to metal debris (21.2%), and fractures of any kind (17.2%). In the six studies that compared BHR to THA, long-term survivorship was similar while BHR exhibited slightly superior activity levels.
The findings from this study suggested favorable long-term survivorship and postoperative outcomes of BHR. In studies comparing long-term BHR and THA, survivorship was comparable, with BHR potentially providing enhanced postoperative activity levels.
在有指征的情况下，伯明翰髋关节表面置换术（BHR）是全髋关节置换术（THA）的一种可行替代方案，但BHR的长期疗效仍存在疑问。因此，我们提出以下问题：1）BHR术后患者报告的长期疗效如何？2）BHR术后的生存率如何？3）BHR术后翻修手术的原因是什么？4）在长期随访中，这些疗效与THA相比如何？
2023年9月对PubMed、MEDLINE、Scopus和Cochrane进行了检索。纳入报告BHR≥10年生存率的文章。生存率定义为任何BHR组件因任何原因进行的翻修。本综述涵盖26篇文章，共13103例髋关节。平均随访时间为6.0至至20.9年，但每项研究至少有一个≥10年随访的亚组分析。
五项研究比较了BHR术前和术后的患者报告结局，四项研究报告在10年随访后至少有一项患者报告结局有所改善。总体而言，在不同的长期时间范围内，生存率从83%到100%不等，26项研究中有25项报告10年生存率大于87%。翻修的主要原因是植入物松动（22%）、对金属碎屑的不良反应（21.2%）和任何类型的骨折（17.2%）。在六项比较BHR和THA的研究中，长期生存率相似，而BHR的活动水平略高。
本研究结果表明BHR具有良好的长期生存率和术后疗效。在比较BHR和THA长期疗效的研究中，生存率相当，BHR可能能提高术后活动水平。
