Risk factors for revision of Birmingham Hip Resurfacing arthroplasty. A single-center study with a median 13-year follow-up

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics Pub Date : 2025-07-14 DOI:10.1016/j.jor.2025.07.013

Alexander Oxblom , Håkan Hedlund , Li Felländer-Tsai , Ola Rolfson , Harald Brismar

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引用次数: 0

Abstract

Background

Consensus is lacking regarding follow-up after metal-on-metal hip resurfacing (MoM-HR). This study examines risk factors for revision and evaluates the need for sequential follow-up.

Patients and methods

288 consecutive patients operated on with a unilateral Birmingham Hip Resurfacing (BHR) 2001–2014, having at least one x-ray and one metal ion sampling, were followed until 2022. Hazard ratios (HR) of revision were calculated for sex, age, femoral component head size, implant positioning, serum cobalt (sCo), and serum chrome (sCr) concentrations. The relative risk (RR) of revision if risk factors were present was calculated. Radiologic changes in component positioning were analyzed in 288 patients, and metal ion changes in 147 patients.

Results

The median follow-up was 13 years. Factors associated with revision were sCo and/or sCr >5 μg/l at first follow-up, a post-operative anteversion <5 or >25°, and femoral head component size <50 mm. Patients with one or more risk factors at first follow-up had a RR of 10 (95 % CI 2.5–42) to be revised compared to those without risk factors. A ≥10° change in the stem shaft angle was associated with an increased OR of revision (OR 14, 95 % CI 4.4–43). A change in sCo and/or sCr from ≤5 to >5 μg/l between follow-ups was associated with an increased risk of revision (OR 8.5, 95 % CI 1.3–55).

Conclusions

Patients with risk factors at first follow-up, a change from serum metal ions ≤5 to >5 μg/l, and a ≥10° change in the stem shaft angle at sequential follow-ups warrant continuous follow-up even if asymptomatic.

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伯明翰髋关节置换术翻修的危险因素。单中心研究，中位随访13年

背景：关于金属对金属髋关节置换术（MoM-HR）后的随访缺乏共识。本研究探讨修订的危险因素，并评估序贯随访的必要性。患者与方法2001-2014年288例连续行单侧伯明翰髋关节置换术（BHR）的患者，至少进行一次x线和一次金属离子取样，随访至2022年。根据性别、年龄、股骨假体头大小、假体定位、血清钴（sCo）和血清铬（sCr）浓度计算翻修的风险比（HR）。如果存在危险因素，计算修订的相对风险（RR）。分析288例患者的放射学变化，147例患者的金属离子变化。结果中位随访时间为13年。与翻修相关的因素是首次随访时sCo和/或sCr为5 μg/l，术后前倾为5°或25°，股骨头组成部分大小为50 mm。与没有危险因素的患者相比，第一次随访时有一个或多个危险因素的患者的RR为10 （95% CI 2.5-42）。柄轴角度≥10°的变化与翻修的OR增加相关（OR 14, 95% CI 4.4-43）。随访期间sCo和/或sCr从≤5至5 μg/l的变化与修订风险增加相关（or 8.5, 95% CI 1.3-55）。结论首次随访时存在危险因素、连续随访时血清金属离子变化≤5 ~ 5 μg/l、茎轴角变化≥10°的患者，即使无症状，也应继续随访。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of orthopaedics ORTHOPEDICS-

CiteScore

3.50

自引率

6.70%

发文量

202

审稿时长

56 days

期刊介绍： Journal of Orthopaedics aims to be a leading journal in orthopaedics and contribute towards the improvement of quality of orthopedic health care. The journal publishes original research work and review articles related to different aspects of orthopaedics including Arthroplasty, Arthroscopy, Sports Medicine, Trauma, Spine and Spinal deformities, Pediatric orthopaedics, limb reconstruction procedures, hand surgery, and orthopaedic oncology. It also publishes articles on continuing education, health-related information, case reports and letters to the editor. It is requested to note that the journal has an international readership and all submissions should be aimed at specifying something about the setting in which the work was conducted. Authors must also provide any specific reasons for the research and also provide an elaborate description of the results.