Short and mid-term outcomes and functional results in metal-on-metal hip resurfacing arthroplasty at 5 years follow-up: the Spanish experience

BACKGROUND: Hip resurfacing arthroplasty (HRA) and in particular, Birmingham hip resurfacing (BHR), is commonly employed as an alternative to total hip arthroplasty (THA) in young patients, as it allows for preservation of femoral bone stock and resumption of physical activity. The aim of our study was to investigate 5-year survival and functional outcomes of BHR arthroplasty in young Spanish osteoarthritis (OA) patients. METHODS: This is an observational, prospective, cohort study of patients who underwent BHR between June 2005 and December 2009 at a Spanish public hospital with a minimum follow-up of 5 years. All surgeries were performed by a single surgeon (RLM). Survival was analyzed using the Kaplan-Meier method. Functional outcomes and return to work and physical activities were also assessed. RESULTS: Five-year survival rate of the prosthesis was 95.74% (95% CI: 95.77–98.07), and estimated 10-year survival was 92.92% (95% CI: 85.07–96.72). Harris hip score significantly increased from 41.13 to 97.63 (p < 0.001) at 5-year follow-up. Average time for returning to work and sporting activities was 3.89 (SD: 2.39) and 3.47 (SD: 1.18) months respectively. Failure occurred in 14 patients, 8 of whom experienced femoral neck fractures. CONCLUSIONS: Our data support the short and mid-term efficacy of BHR arthroplasty in young OA patients, indicating good implant survival, improvement in patients’ functionality and a swift return to work and physical activities after surgery.