How the Birmingham Hip Resurfacing System Works

The Birmingham Hip Resurfacing System was the first FDA-approved hip resurfacing system available for use in the United States. Hip resurfacing is an alternative to traditional total hip replacement for some patients. It was approved by the FDA on May 9, 2006.

First introduced in 1997 in the United Kingdom, the Birmingham Hip has been used in 26 other countries and has been implanted in thousands of patients.

This article looks at the Birmingham System, how it works, and what some of its pros and cons are.

How the Birmingham System Works

The Birmingham Hip Resurfacing System is used to replace parts of a damaged hip. Hip resurfacing may be considered if your hip has been damaged by osteoarthritis, rheumatoid arthritis, traumatic arthritis, dysplasia, or avascular necrosis.

The Birmingham Hip Resurfacing System is designed to conserve more bone than a traditional hip replacement. In younger patients, this helps make it possible to perform additional surgeries later in life, including total hip replacement.

The Birmingham Hip is a two-part system. First, the ball at the end of the femur bone is resurfaced so a metal cap can be placed over it. Then, the surgeon fits a metal cup into the pelvic socket (acetabulum).

The Birmingham Hip is a metal-on-metal joint. Essentially, the procedure smooths the worn areas of the ball-and-socket joint with durable high-carbide cobalt chrome. This eliminates pain and returns natural motion to the hip.

The hip resurfacing procedure has a high reported success rate of more than 94%.

Pros and Cons of Hip Resurfacing

Hip resurfacing may be a good choice for people who are young and active. The surgery does have certain disadvantages, however, along with its potential advantages.

Pros of Hip Resurfacing

• The recovery time tends to be shorter, with less time spent in the hospital and less time before normal activities can be resumed.
• The joint may be better able to withstand higher-impact activities like running.
• It may last longer than a traditional hip replacement.
• The larger ball is more stable and at less risk for dislocating.
• The surgery preserves bone so revision surgery can be done in the future, if necessary.

Cons of Hip Resurfacing

• The potential health impacts of metal debris that may result from a metal-on-metal joint is not well understood.
• There is a small risk of nerve injury and associated muscle weakness in the leg.
• There is also a small risk of fracture, especially in older females.
• The surgery is much more difficult than traditional hip replacement so it may be harder to find a qualified surgeon.
  

Is the Birmingham Hip Right for You?

A metal-on-metal joint, such as the Birmingham Hip, eliminates problems with wear typically seen in traditional hip replacements. Wear is recognized as a cause of loosening of the hip prostheses.

The Birmingham Hip is not usually recommended for older people or for those who are not active. The resurfacing system is also not appropriate for people who have:

• An infection in the body or blood
• Bones that are not fully grown
• Blood vessel-related disease, muscle-related disease, or nerve-and-muscle-related disease that will prevent stability of the Birmingham Hip or may interfere with recovery
• Bones that are not healthy or strong enough due to osteoporosis
• A family history of bone loss
• Multiple fluid-filled cavities (cysts) greater than 1 centimeter (cm) in the femoral head
  
• Significantly impaired kidney function
• Metal sensitivity
• A suppressed immune system due to diseases such as AIDS 

It's also not recommended for:

• Female of child-bearing age, since it is unknown whether metal ions released by the device could harm an unborn child
• People who receive high doses of corticosteroids
• Those who are obese or severely overweight

Most health insurers, including Medicare, will cover hip resurfacing. You may need to meet certain criteria, however, such as being under 65 years of age and trying non-surgical treatments first.

Costs vary widely according to the location where the surgery is performed, but the overall cost of hip resurfacing tends to be lower than hip replacement. One study found that the average cost of hip resurfacing was $26,000, while hip replacement cost an average of $50,000.

Summary

The Birmingham Hip Resurfacing System is an alternative to traditional hip replacement. It is usually done in younger, more active people. The major advantage of the surgery is that it preserves bone so additional surgeries can be done in the future, if necessary. It may also last longer and be less likely to dislocate than a traditional hip replacement.

Some people aren't good candidates for hip resurfacing. These include people with certain medical problems such as osteoporosis, kidney problems, or a suppressed immune system.

A Word From Verywell

Not all people who need a hip replacement will be good candidates for the Birmingham Hip Resurfacing System. It is best for you to know your options and to discuss them with your healthcare provider. Based on your medical history, your practitioner will advise you and make a recommendation with regard to the best procedure for you.