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 arthritis patients. It was approved by the U.S. FDA on May 9, 2006.



Birmingham hip resurfacing system

Smith & Nephew

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. Smith & Nephew is the manufacturer of the Birmingham Hip Resurfacing System.


Preparing Hip for Resurfacing

The Birmingham Hip Resurfacing System relieves hip pain and improves hip function by replacing parts of the damaged hip. The hip may have 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. By conserving more bone, younger patients preserve future surgery options, including a traditional hip replacement, if later needed.

The Birmingham Hip is a two-part system. A metal cap is placed over the resurfaced femoral ball. A metal cup fits into the pelvic socket or acetabulum. The Birmingham Hip is a metal-on-metal joint.

The ball of the femur (as illustrated) is resurfaced before the metal cap is fit over it. Essentially, the Birmingham Hip smooths the worn areas of the ball-and-socket joint with durable high-carbide cobalt chrome, eliminating pain and returning a natural motion to the hip.


Metal-on-Metal/Full Implant

A metal-on-metal joint, such as the Birmingham Hip, eliminates problems caused by polyethylene wear in traditional hip replacements which have a plastic liner in the acetabular component. Polyethylene wear is recognized as a cause of loosening of hip prostheses.

The Birmingham Hip is designed for young, active patients. It is not recommended for the elderly or inactive patients. The resurfacing system is also not appropriate in the following situations:

  • Patient has an infection in the body or blood.
  • Patient has bones that are not full grown.
  • Patient has a 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 the recovery phase.
  • Patient's bones are not healthy or strong enough due to osteoporosis, or there is a family history of bone loss; or if there are multiple fluid-filled cavities (cysts) greater than 1 centimeter in the femoral head.
  • Patient is female and of child-bearing age since it is unknown whether metal ions released by the device could harm an unborn child.
  • Patient has a kidney with significantly impaired function.
  • Patient has metal sensitivity.
  • Patient has a suppressed immune system due to diseases such as AIDS or receives high doses of corticosteroids.
  • Patient is obese or severely overweight.

Bottom Line

Not all arthritis patients who need a hip replacement will be an ideal candidate 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.

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  • Medical Devices. FDA. Birmingham Hip Resurfacing (BHR) System - P040033. Updated 09/05/2013.
  • Smith & Nephew Receives FDA Approval For Birmingham Hip Resurfacing System, May 10, 2006