Our Summary

This research paper reviews the long-term results (10-15 years) of a type of hip replacement surgery called metal-on-metal hip resurfacing (MoM HR). The paper looks at outcomes from both the centers that designed the procedure and independent centers that also perform it. Two specific designs, the Birmingham Hip Resurfacing (BHR) and the Conserve Plus, are examined.

The paper found that the BHR design showed good results, with the hip replacement lasting up to 15 years in 95.8% of cases performed by the design center, and 10 years in 87.1-94.5% of cases performed at independent centers. The results varied depending on factors such as the reason for the operation (those with primary osteoarthritis did better), the patient’s sex (men did better), and the size of the femoral component used in the surgery (bigger was better).

The study concludes that MoM HR is still a good option for younger, active male patients with primary osteoarthritis, as long as the surgeon is experienced, the implant used has a proven track record, and the patient is aware of the potential risks. For very experienced surgeons, the procedure may also work well for women, provided certain conditions are met.

FAQs

  1. What is the long-term success rate of the Birmingham Hip Resurfacing design?
  2. What factors can influence the success of a metal-on-metal hip resurfacing procedure?
  3. Is the metal-on-metal hip resurfacing procedure suitable for all patients?

Doctor’s Tip

A doctor may advise a patient considering hip replacement surgery to carefully consider the type of implant being used, the experience of the surgeon, and their own specific circumstances. In the case of metal-on-metal hip resurfacing, it may be a good option for younger, active male patients with primary osteoarthritis, as long as certain criteria are met. It’s important for patients to be informed about the potential risks and to have realistic expectations about the long-term outcomes of the surgery.

Suitable For

In general, patients who are typically recommended for hip replacement surgery include those who have severe hip pain that limits their daily activities, have not experienced relief from non-surgical treatments such as medication or physical therapy, have arthritis that has damaged the hip joint, have hip fractures, or have other conditions that cause hip joint damage. Additionally, younger, more active patients may be recommended for hip replacement surgery if they have exhausted other treatment options and are experiencing significant pain and limitations in their daily activities. It is important for patients to discuss their individual circumstances with their healthcare provider to determine if hip replacement surgery is the best option for them.

Timeline

  • Patient experiences hip pain, stiffness, and limited mobility, leading to consultation with a doctor
  • Doctor recommends hip replacement surgery as a treatment option
  • Patient undergoes pre-operative assessments and consultations to determine candidacy for surgery
  • Patient schedules surgery and prepares for the procedure, including pre-operative instructions and medical clearance
  • Patient undergoes hip replacement surgery, which typically takes a few hours and involves replacing the damaged hip joint with an artificial implant
  • Patient stays in the hospital for a few days for post-operative care and rehabilitation
  • Patient begins physical therapy and rehabilitation to regain strength, mobility, and function in the hip
  • Patient follows post-operative instructions, including pain management, wound care, and activity restrictions
  • Patient gradually resumes normal activities and experiences improved hip function and decreased pain
  • Patient follows up with the surgeon for post-operative appointments and monitoring of the hip replacement
  • Patient enjoys long-term benefits of hip replacement, such as improved quality of life, increased mobility, and reduced pain.

What to Ask Your Doctor

Some questions a patient should ask their doctor about hip replacement surgery, especially in the context of metal-on-metal hip resurfacing, include:

  1. What are the specific risks and benefits of metal-on-metal hip resurfacing compared to other types of hip replacement surgery?
  2. What is the long-term success rate of metal-on-metal hip resurfacing, particularly with the BHR and Conserve Plus designs?
  3. Am I a suitable candidate for metal-on-metal hip resurfacing based on my age, activity level, and the reason for my hip replacement?
  4. How experienced are you in performing metal-on-metal hip resurfacing surgeries, and what is your success rate with this procedure?
  5. What are the potential complications or risks associated with metal-on-metal hip resurfacing, and how likely are they to occur in my case?
  6. How will you monitor and follow up on the performance of my metal-on-metal hip resurfacing implant in the long term?
  7. Are there any alternative treatment options to metal-on-metal hip resurfacing that I should consider?
  8. What steps will be taken to ensure that the implant used in my surgery has a proven track record and is safe for long-term use?
  9. What pre-surgery preparation and post-surgery care will be required for a successful metal-on-metal hip resurfacing procedure?
  10. How can I best support the longevity and effectiveness of my metal-on-metal hip resurfacing implant in the years following the surgery?

Reference

Authors: Matharu GS, Pandit HG, Murray DW, Treacy RB. Journal: Int Orthop. 2015 Oct;39(10):2031-6. doi: 10.1007/s00264-015-2692-z. Epub 2015 Feb 24. PMID: 25708400