Abstract：
UNASSIGNED: The Birmingham Hip Resurfacing (BHR) was introduced in 1997 to address the needs of young active patients using a historically proven large-diameter metal-on-metal (MoM) bearing. A single designer surgeon\'s consecutive series of 130 patients (144 hips) was previously reported at five and ten years, reporting three and ten failures, respectively. The aim of this study was to extend the follow-up of this original cohort at 25 years.
UNASSIGNED: The study extends the reporting on the first consecutive 144 resurfacing procedures in 130 patients for all indications. All operations were undertaken between August 1997 and May 1998. The mean age at operation was 52.1 years (SD 9.93; 17 to 76), and included 37 female patients (28.5%). Failure was defined as revision of either component for any reason. Kaplan-Meier survival analysis was performed. Routine follow-up with serum metal ion levels, radiographs, and Oxford Hip Scores (OHSs) was undertaken.
UNASSIGNED: Overall implant survival was 83.50% (95% confidence interval (CI) 0.79 to 0.90) at 25 years, and the number at risk was 79. Survival in male patients at 25 years was 89.5% (95% CI 0.83 to 0.96) compared to 66.9% for female patients (95% CI 0.51 to 0.83). Ten additional failures occurred in the period of ten to 25 years. These involved an adverse reaction to metal debris in four patients, a periprosthetic femoral neck fracture affecting five patients, and aseptic loosening in one patient. The median chromium levels were 49.50 nmol/l (interquartile range (IQR) 34 to 70), and the median cobalt serum levels were 42 nmol/l (IQR 24.50 to 71.25). The median OHS at last follow-up was 35 (IQR 10 to 48). During the 25-year study period, 29 patients died. Patient survival at 25 years was 75.10% (95% CI 0.67 to 0.83).
UNASSIGNED: This study demonstrates that MoM hip resurfacing using the BHR provides a durable alternative to total hip arthroplasty (THA), particularly in younger male patients with osteoarthritis wishing to maintain a high level of function. These results compare favourably to the best results for THAs.
UNASSIGNED: The study extends the reporting on the first consecutive 144 resurfacing procedures in 130 patients for all indications. All operations were undertaken between August 1997 and May 1998. The mean age at operation was 52.1 years (SD 9.93; 17 to 76), and included 37 female patients (28.5%). Failure was defined as revision of either component for any reason. Kaplan-Meier survival analysis was performed. Routine follow-up with serum metal ion levels, radiographs, and Oxford Hip Scores (OHSs) was undertaken.
UNASSIGNED: Overall implant survival was 83.50% (95% confidence interval (CI) 0.79 to 0.90) at 25 years, and the number at risk was 79. Survival in male patients at 25 years was 89.5% (95% CI 0.83 to 0.96) compared to 66.9% for female patients (95% CI 0.51 to 0.83). Ten additional failures occurred in the period of ten to 25 years. These involved an adverse reaction to metal debris in four patients, a periprosthetic femoral neck fracture affecting five patients, and aseptic loosening in one patient. The median chromium levels were 49.50 nmol/l (interquartile range (IQR) 34 to 70), and the median cobalt serum levels were 42 nmol/l (IQR 24.50 to 71.25). The median OHS at last follow-up was 35 (IQR 10 to 48). During the 25-year study period, 29 patients died. Patient survival at 25 years was 75.10% (95% CI 0.67 to 0.83).
UNASSIGNED: This study demonstrates that MoM hip resurfacing using the BHR provides a durable alternative to total hip arthroplasty (THA), particularly in younger male patients with osteoarthritis wishing to maintain a high level of function. These results compare favourably to the best results for THAs.
摘要：
■伯明翰髋关节表面置换术（BHR）于1997年推出，旨在使用历史悠久的大直径金属对金属（MoM）轴承来满足年轻活跃患者的需求。以前曾报道过一位设计师外科医生连续的130名患者（144髋）在五年和十年中，报告三次和十次失败，分别。这项研究的目的是将该原始队列的随访时间延长至25年。
■该研究扩展了130例患者中所有适应症的首次连续144例表面置换手术的报告。所有行动都是在1997年8月至1998年5月期间进行的。手术平均年龄为52.1岁（SD9.93；17至76），其中女性患者37例(28.5%)。失败被定义为出于任何原因的任一组件的修订。进行Kaplan-Meier生存分析。常规随访血清金属离子水平，射线照片,和牛津髋关节得分（OHSs）进行。
■25年时，植入物的总生存率为83.50％（95％置信区间（CI）0.79至0.90），有风险的人数是79。男性患者25岁时的生存率为89.5%（95%CI0.83至0.96），女性患者为66.9%（95%CI0.51至0.83）。在10到25年的时间内发生了十次额外的故障。这些涉及四名患者对金属碎片的不良反应，影响五名患者的假体周围股骨颈骨折，一名患者无菌性松动。中值铬水平为49.50nmol/l（四分位距（IQR）34至70），钴血清水平中位数为42nmol/l（IQR24.50至71.25）。末次随访时OHS中位数为35（IQR10至48）。在25年的研究期间，29例患者死亡。患者25年生存率为75.10%（95%CI0.67~0.83）。
■这项研究表明，使用BHR的MoM髋关节置换术提供了全髋关节置换术（THA）的持久替代方案，特别是希望维持高水平功能的年轻男性骨关节炎患者。这些结果与THA的最佳结果相比是有利的。
■该研究扩展了130例患者中所有适应症的首次连续144例表面置换手术的报告。所有行动都是在1997年8月至1998年5月期间进行的。手术平均年龄为52.1岁（SD9.93；17至76），其中女性患者37例(28.5%)。失败被定义为出于任何原因的任一组件的修订。进行Kaplan-Meier生存分析。常规随访血清金属离子水平，射线照片,和牛津髋关节得分（OHSs）进行。
■25年时，植入物的总生存率为83.50％（95％置信区间（CI）0.79至0.90），有风险的人数是79。男性患者25岁时的生存率为89.5%（95%CI0.83至0.96），女性患者为66.9%（95%CI0.51至0.83）。在10到25年的时间内发生了十次额外的故障。这些涉及四名患者对金属碎片的不良反应，影响五名患者的假体周围股骨颈骨折，一名患者无菌性松动。中值铬水平为49.50nmol/l（四分位距（IQR）34至70），钴血清水平中位数为42nmol/l（IQR24.50至71.25）。末次随访时OHS中位数为35（IQR10至48）。在25年的研究期间，29例患者死亡。患者25年生存率为75.10%（95%CI0.67~0.83）。
■这项研究表明，使用BHR的MoM髋关节置换术提供了全髋关节置换术（THA）的持久替代方案，特别是希望维持高水平功能的年轻男性骨关节炎患者。这些结果与THA的最佳结果相比是有利的。
