Smith and Nephew

BHR Clinical Results

BIRMINGHAM HIP Resurfacing System


We've collected some of the studies that illustrate the safety and effectiveness of the BHR Hip. While the content may be written for orthopedic surgeons, you may find it helpful to review the abstracts in the course of your research.

2012 Australian Registry

Table HT 78. Australian Orthopaedic Association National Joint Replacement Registry Annual Report. Adelaide: AOA; 2012.

The Australian Joint Replacement Registry annual report contains data from September 1999 to December 2011 and has one of the most complete national datasets. The information is extremely useful to compare unbiased clinical results of various primary total resurfacing hip replacements and primary total hip prostheses, and highlights the continuing exceptional clinical performance of the BIRMINGHAM HIP Resurfacing System. The BHR system accounted for 10,133 implants or 68% of primary total resurfacing hip replacements.

Summary of Resurfacing patient data
(September 1999 to December 2011)

  • 90.8% of all resurfacing total hip replacement patients, who presented with a primary diagnosis of osteoarthritis only, were under the age of 65.
  • 77.2% of resurfacing total hip replacements patients who presented with a primary diagnosis of osteoarthritis only, were male.
  • BHR accounted for 75.4% of all resurfacing procedures in 2011.
  • BHR is the only resurfacing prosthesis with more than 10 years of registry data.
  • Eleven year revision rates for the BHR total hip replacement are 7.1%. These are the best results in the resurfacing total hip replacement cohort who have clinical results of seven years or longer.

Great Britain's Oswestry Outcomes Centre's patient registry


The Oswestry Outcomes Centre's patient registry shows the BHR Hip's 10-year survivorship of 95.4%, with 98.6% of patients rating their opinion of the experience as "pleased" or "extremely pleased." This registry includes 569 BHR hips implanted by 21 different surgeons in 17 countries.

Journal for Bone and Joint Surgery

Langton DJ, Jameson SS, Joyce TJ, Hallab NJ, Natu S, Nargol AVF. Early failure of metal-on-metal bearings in hip resurfacing and large-diameter total hip replacement, A CONSEQUENCE OF EXCESS WEAR. J Bone Joint Surg Br. 2010; 92-B: 38-46

This peer-reviewed article from the January 2010 edition of the Journal for Bone and Joint Surgery discusses the success of the BHR Hip relative to another device. In this study, 155 consecutive BHR Hip patients were tracked, and the author found that none were revised due to metal wear debris. In the same study, the author also tracked 505 metal on metal implants from a different manufacturer and found revision rates of 5.9% and 11.4%, respectively, for two of this company's implant designs.

Source Article

American Academy of Orthopaedic Surgeons 2010 Annual Meeting

Beaule PE, Smith FC, Powell JN et al. A Survey on the Incidence of Pseudotumours with MOM Hip Resurfacings in Canadian Academic Centres. Podium presentation #665. Proceedings of the American Academy of Orthopaedic Surgeons Annual Meeting, New Orleans LA. 2010

This multi-site study, performed by orthopaedic surgeons practicing at nine Canadian academic centers, showed that three years after surgery, 99.91% of their 3,400 hip resurfacing patients experienced no implant failure due to metal wear debris. The BHR Hip was the most used resurfacing device in this study.

Source Article

Journal of Engineering in Medicine

Visuri TI, Pukkala E, Pulkkinen P, Paavolainen P. Cancer incidence and causes of death among total hip replacement patients: a review based on Nordic cohorts with a special emphasis on metal-on-metal bearings 2005. Proc. IMechE Vol. 220 Part H: J; 399-407.

As Derek McMinn said at the May 6, 2010, press conference, the composition of the metal used in the BHR Hip has a long track record of safety. This paper notes that over a 28-year period, there is no increased incidence of cancer among patients who received a particular metal-on-metal hip (known as McKee-Farrar) when compared to the general population. The metal used to make the BHR Hip is based on this McKee-Farrar component. This data comes from patient registries in Sweden, Norway, Finland and Denmark.

Source Article

American Academy of Orthopaedic Surgeons 2010 Annual Meeting

Graves S, De Steiger R, Davidson D, Ryan P, Miller L, Stanford T, Tomkins A. Resurfacing Hip Replacement: Outcomes at 8 years - An analysis of 12,093 primary procedures. Podium presentation # 669. Proceedings of the American Academy of Orthopaedic Surgeons Annual Meeting, New Orleans LA. 2010

This study, presented at the 2010 annual meeting of the American Academy of Orthopaedic Surgeons, reinforces what Dr. Edwin Su spoke about at the March 6, 2010, press conference. That is, the success of a hip resurfacing procedure depends on patient and implant selection.

Source Article

Journal for Bone and Joint Surgery (British edition)

Heilpern GNA, Shah NN, Fordyce MJF. Birmingham hip resurfacing arthroplasty: A SERIES OF 110 CONSECUTIVE HIPS WITH A MINIMUM FIVEYEAR CLINICAL AND RADIOLOGICAL FOLLOW-UP. J Bone Joint Surg Br. 2008;90-B(9):1137-1142.

This study tracked the performance of 110 BHR Hips over a 5-year span. Excerpts from the author's conclusions include: "Survivorship compares well with similar studies using conventional hip replacements, and concerns regarding high rates of early complications and failures are not borne out... Our results, which include the surgeon's learning experience with the BHR, show a 96.3% survival at five years and do not differ greatly from the results achieved by the surgeon-inventors group. This gives us confidence to continue using this implant."

Source Article

Acta Orthopaedica Belgica

Malviya Ajay, Holland James P. Pseudotumours associated with metal-on-metal hip resurfacing: 10-year Newcastle experience. Acta Orthopaedica Belgica. August 2009, 75 (4) p477-83.

In a 10-year study published last year in Acta Orthopaedica Belgica, the official journal of the Belgian Society of Orthopaedics and Traumatology, a single-surgeon series of BHR Hip patients resulted in 2 adverse tissue reactions in 670 procedures (0.18%). In the report, the authors note: "In our experience the risk of pseudotumours is low (0.15%) and can be fully explained. In selected cases the bearing surface can be retained."

Source Article

Not every surgeon has been trained to perform BIRMINGHAM Hip Resurfacing. To find a surgeon trained in BIRMINGHAM Hip Resurfacing near you, use our Find a Physician locator.

Important notes

There are potential risks with hip resurfacing surgery such as fracture, infection, loosening, dislocation and wear that may result in the need for additional surgery. The results and physical activities of this patient may not be representative of the results and physical activities that you may experience following surgery. Females should not have the BHR device. It is unknown whether metal ions released by the device could harm an unborn child. Do not perform high impact activities such as running and jumping during the first post operative year while the bone is healing. Early device failure, breakage or loosening may occur if you do not follow your surgeon's limitations on activity level. Early failure can happen if you do not guard your hip joint from overloading due to activity level, failure to control body weight, or accidents such as falls. Hip resurfacing surgery is intended to relieve hip pain and improve hip function. Talk to your doctor to determine what treatment may be best for you.

The information listed on this site is for informational and educational purposes and is not meant as medical advice. Every patient's case is unique and each patient should follow his or her doctor's specific instructions. Please discuss nutrition, medication and treatment options with your doctor to make sure you are getting the proper care for your particular situation.


BHR MRI safety information

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