Birmingham hip resurfacing and the ASR at a minimum of 10 years : a prospective cohort study

We performed a prospective cohort study to assess whether the Birmingham Hip Resurfacing (BHR) and ASR are compliant with NICE guideline recommendations at 10 years. This is the first study in the literature to directly compare these two implants with respect to their NICE-compliance rates. Only ASR and BHR implants were included in the analysis. Patients were prospectively reviewed at 6 months, 2 years, 5 years and 10 years. Outcome measures included the following : revision, re-revision, cause for revision, time to revision, length of stay (LOS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores at each review. Three hundred and ninety-two hip resurfacings were performed on 364 patients. For the ASR, 26/119 implants were revised giving a 78.2% 10-year survival rate. The BHR had a 95.7% 10-year survival rate, in keeping with NICE recommendations. The ASR had a significantly higher all-cause revision rate when compared to the BHR at 10 years (p<0.05). BHR is a NICE-compliant implant at 10 years. The ASR fell short of NICE 10-year recommended revision rates in just under 2 years. We suggest that the BHR still has a role in hip osteoarthritis hip in high-demand males.