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.
Smith & Nephew
How the Birmingham System Works
The Birmingham Hip Resurfacing System is designed to conserve more bone than a traditional hip replacement. In younger people, 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
Cons of Hip Resurfacing
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:
It’s also not recommended for:
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.
Frequently Asked QuestionsWith hip resurfacing, the surgeon first trims away damaged cartilage and bone, then covers the hip socket and thigh bone with metal implants. In a hip replacement, the surgeon removes and replaces the entire head of the thigh bone and hip socket.In general, hip resurfacing is recommended for people with hip osteoarthritis who are younger, fit, and active with strong healthy bones. It is more commonly performed in men in their early 50s and should not be done in people over 65. That said, recommendations depend on the person and method of resurfacing.The surgery will take between one and a half and three hours to complete. After the surgery, you will likely stay in the hospital for one to four days.At least 10 years and possibly even 15. A 2021 study found that 92.9% of BHR joints were still working properly after 10 years.Another study reported that 97.4% of BHR joints were still good at 10 years and 95.8% were still going strong at 15 years.There is a decreased risk of hip dislocation because the resurfacing ball is larger and closer to the size of a natural femur ball.Walking patterns are also more natural after a hip resurfacing than a hip replacement. Hip resurfacing is also easier to revise if needed.It will take at least six weeks after Birmingham Hip Resurfacing surgery to recover to the point of doing daily activities without pain. Your orthopedic surgeon will likely recommend physical therapy to regain hip strength, range of motion, and function.In 2015, manufacturer Smith & Nephew voluntarily recalled femoral heads that were 46 millimeters (mm) in diameter and smaller due to a greater risk of dislocation and a need for revision surgery. Patients do not need to take any action unless the artificial joint is causing them problems or pain.
Frequently Asked Questions
With hip resurfacing, the surgeon first trims away damaged cartilage and bone, then covers the hip socket and thigh bone with metal implants. In a hip replacement, the surgeon removes and replaces the entire head of the thigh bone and hip socket.
In general, hip resurfacing is recommended for people with hip osteoarthritis who are younger, fit, and active with strong healthy bones. It is more commonly performed in men in their early 50s and should not be done in people over 65. That said, recommendations depend on the person and method of resurfacing.
The surgery will take between one and a half and three hours to complete. After the surgery, you will likely stay in the hospital for one to four days.
At least 10 years and possibly even 15. A 2021 study found that 92.9% of BHR joints were still working properly after 10 years.Another study reported that 97.4% of BHR joints were still good at 10 years and 95.8% were still going strong at 15 years.
There is a decreased risk of hip dislocation because the resurfacing ball is larger and closer to the size of a natural femur ball.Walking patterns are also more natural after a hip resurfacing than a hip replacement. Hip resurfacing is also easier to revise if needed.
It will take at least six weeks after Birmingham Hip Resurfacing surgery to recover to the point of doing daily activities without pain. Your orthopedic surgeon will likely recommend physical therapy to regain hip strength, range of motion, and function.
In 2015, manufacturer Smith & Nephew voluntarily recalled femoral heads that were 46 millimeters (mm) in diameter and smaller due to a greater risk of dislocation and a need for revision surgery. Patients do not need to take any action unless the artificial joint is causing them problems or pain.
13 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Issa K, Palich A, Tatevossian T, et al.The outcomes of hip resurfacing compared to standard primary total hip arthroplasty in men.BMC Musculoskelet Disord.2013;14(1):1-6. doi:10.1186/1471-2474-14-161Haddad FS, Konan S, Tahmassebi J.A prospective comparative study of cementless total hip arthroplasty and hip resurfacing in patients under the age of 55 years: a ten-year follow-up.Bone Joint J. 2015;97(5):617-22. doi:10.1302/0301-620X.97B5.34537Girard J, Miletic B, Deny A, Migaud H, Fouilleron N.Can patients return to high-impact physical activities after hip resurfacing? A prospective study.Int Orthop. 2013;37(6):1019-24. doi:10.1007/s00264-013-1834-4Marshall DA, Pykerman K, Werle J, et al.Hip resurfacing versus total hip arthroplasty: a systematic review comparing standardized outcomes.Clin Orthop Relat Res. 2014;472(7):2217-30. doi:10.1007/s11999-014-3556-3Hannemann F, Hartmann A, Schmitt J, et al.European multidisciplinary consensus statement on the use and monitoring of metal-on-metal bearings for total hip replacement and hip resurfacing.Orthop Traumatol Surg Res. 2013;99(3):263-71. doi:10.1016/j.otsr.2013.01.005Nam D, Nunley RM, Ruh EL, et al.Short-term results of Birmingham hip resurfacing in the United States.Orthopedics. 2015;38(8):e715-21. doi:10.3928/01477447-20150804-60Gaillard EB, Gaillard MD, Gross TP.Interventions for improving hip resurfacing outcomes in women: a high-volume, retrospective study.J Arthroplasty. 2017;32(11):3404-11. doi:10.1016/j.arth.2017.06.003Kahlenberg CA, Swarup I, Krell EC, Heinz N, Figgie MP.Causes of revision in young patients undergoing total hip arthroplasty.J Arthroplasty. 2019;34(7):1435-40. doi:10.1016/j.arth.2019.03.014Gaillard-Campbell MD, Fowble C, Webb L, Gross TP.Hip resurfacing as an outpatient procedure: a comparison of overall cost and review of safety.Musculoskelet Surg. 2021;105(1):111-6. doi:10.1007/s12306-020-00637-zSu EP, Ho H, Bhal V, et al.Results of the first U.S. FDA-approved hip resurfacing device at 10-year follow-up.J Bone Joint Surg Am. 2021;103(14):1303–11. doi:10.2106/JBJS.20.01886Daniel J, Pradhan C, Ziaee H, Pynsent PB, McMinn DJ.Results of Birmingham hip resurfacing at 12 to 15 years: a single-surgeon series.Bone Joint J. 2014;96-B(10):1298–306. doi:10.1302/0301-620X.96B10.33695American Academy of Orthopaedic Surgeons: OrthoInfo.Hip resurfacing.Smith and Nephew.Statement regarding BHR system.
13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Issa K, Palich A, Tatevossian T, et al.The outcomes of hip resurfacing compared to standard primary total hip arthroplasty in men.BMC Musculoskelet Disord.2013;14(1):1-6. doi:10.1186/1471-2474-14-161Haddad FS, Konan S, Tahmassebi J.A prospective comparative study of cementless total hip arthroplasty and hip resurfacing in patients under the age of 55 years: a ten-year follow-up.Bone Joint J. 2015;97(5):617-22. doi:10.1302/0301-620X.97B5.34537Girard J, Miletic B, Deny A, Migaud H, Fouilleron N.Can patients return to high-impact physical activities after hip resurfacing? A prospective study.Int Orthop. 2013;37(6):1019-24. doi:10.1007/s00264-013-1834-4Marshall DA, Pykerman K, Werle J, et al.Hip resurfacing versus total hip arthroplasty: a systematic review comparing standardized outcomes.Clin Orthop Relat Res. 2014;472(7):2217-30. doi:10.1007/s11999-014-3556-3Hannemann F, Hartmann A, Schmitt J, et al.European multidisciplinary consensus statement on the use and monitoring of metal-on-metal bearings for total hip replacement and hip resurfacing.Orthop Traumatol Surg Res. 2013;99(3):263-71. doi:10.1016/j.otsr.2013.01.005Nam D, Nunley RM, Ruh EL, et al.Short-term results of Birmingham hip resurfacing in the United States.Orthopedics. 2015;38(8):e715-21. doi:10.3928/01477447-20150804-60Gaillard EB, Gaillard MD, Gross TP.Interventions for improving hip resurfacing outcomes in women: a high-volume, retrospective study.J Arthroplasty. 2017;32(11):3404-11. doi:10.1016/j.arth.2017.06.003Kahlenberg CA, Swarup I, Krell EC, Heinz N, Figgie MP.Causes of revision in young patients undergoing total hip arthroplasty.J Arthroplasty. 2019;34(7):1435-40. doi:10.1016/j.arth.2019.03.014Gaillard-Campbell MD, Fowble C, Webb L, Gross TP.Hip resurfacing as an outpatient procedure: a comparison of overall cost and review of safety.Musculoskelet Surg. 2021;105(1):111-6. doi:10.1007/s12306-020-00637-zSu EP, Ho H, Bhal V, et al.Results of the first U.S. FDA-approved hip resurfacing device at 10-year follow-up.J Bone Joint Surg Am. 2021;103(14):1303–11. doi:10.2106/JBJS.20.01886Daniel J, Pradhan C, Ziaee H, Pynsent PB, McMinn DJ.Results of Birmingham hip resurfacing at 12 to 15 years: a single-surgeon series.Bone Joint J. 2014;96-B(10):1298–306. doi:10.1302/0301-620X.96B10.33695American Academy of Orthopaedic Surgeons: OrthoInfo.Hip resurfacing.Smith and Nephew.Statement regarding BHR system.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Issa K, Palich A, Tatevossian T, et al.The outcomes of hip resurfacing compared to standard primary total hip arthroplasty in men.BMC Musculoskelet Disord.2013;14(1):1-6. doi:10.1186/1471-2474-14-161Haddad FS, Konan S, Tahmassebi J.A prospective comparative study of cementless total hip arthroplasty and hip resurfacing in patients under the age of 55 years: a ten-year follow-up.Bone Joint J. 2015;97(5):617-22. doi:10.1302/0301-620X.97B5.34537Girard J, Miletic B, Deny A, Migaud H, Fouilleron N.Can patients return to high-impact physical activities after hip resurfacing? A prospective study.Int Orthop. 2013;37(6):1019-24. doi:10.1007/s00264-013-1834-4Marshall DA, Pykerman K, Werle J, et al.Hip resurfacing versus total hip arthroplasty: a systematic review comparing standardized outcomes.Clin Orthop Relat Res. 2014;472(7):2217-30. doi:10.1007/s11999-014-3556-3Hannemann F, Hartmann A, Schmitt J, et al.European multidisciplinary consensus statement on the use and monitoring of metal-on-metal bearings for total hip replacement and hip resurfacing.Orthop Traumatol Surg Res. 2013;99(3):263-71. doi:10.1016/j.otsr.2013.01.005Nam D, Nunley RM, Ruh EL, et al.Short-term results of Birmingham hip resurfacing in the United States.Orthopedics. 2015;38(8):e715-21. doi:10.3928/01477447-20150804-60Gaillard EB, Gaillard MD, Gross TP.Interventions for improving hip resurfacing outcomes in women: a high-volume, retrospective study.J Arthroplasty. 2017;32(11):3404-11. doi:10.1016/j.arth.2017.06.003Kahlenberg CA, Swarup I, Krell EC, Heinz N, Figgie MP.Causes of revision in young patients undergoing total hip arthroplasty.J Arthroplasty. 2019;34(7):1435-40. doi:10.1016/j.arth.2019.03.014Gaillard-Campbell MD, Fowble C, Webb L, Gross TP.Hip resurfacing as an outpatient procedure: a comparison of overall cost and review of safety.Musculoskelet Surg. 2021;105(1):111-6. doi:10.1007/s12306-020-00637-zSu EP, Ho H, Bhal V, et al.Results of the first U.S. FDA-approved hip resurfacing device at 10-year follow-up.J Bone Joint Surg Am. 2021;103(14):1303–11. doi:10.2106/JBJS.20.01886Daniel J, Pradhan C, Ziaee H, Pynsent PB, McMinn DJ.Results of Birmingham hip resurfacing at 12 to 15 years: a single-surgeon series.Bone Joint J. 2014;96-B(10):1298–306. doi:10.1302/0301-620X.96B10.33695American Academy of Orthopaedic Surgeons: OrthoInfo.Hip resurfacing.Smith and Nephew.Statement regarding BHR system.
Issa K, Palich A, Tatevossian T, et al.The outcomes of hip resurfacing compared to standard primary total hip arthroplasty in men.BMC Musculoskelet Disord.2013;14(1):1-6. doi:10.1186/1471-2474-14-161
Haddad FS, Konan S, Tahmassebi J.A prospective comparative study of cementless total hip arthroplasty and hip resurfacing in patients under the age of 55 years: a ten-year follow-up.Bone Joint J. 2015;97(5):617-22. doi:10.1302/0301-620X.97B5.34537
Girard J, Miletic B, Deny A, Migaud H, Fouilleron N.Can patients return to high-impact physical activities after hip resurfacing? A prospective study.Int Orthop. 2013;37(6):1019-24. doi:10.1007/s00264-013-1834-4
Marshall DA, Pykerman K, Werle J, et al.Hip resurfacing versus total hip arthroplasty: a systematic review comparing standardized outcomes.Clin Orthop Relat Res. 2014;472(7):2217-30. doi:10.1007/s11999-014-3556-3
Hannemann F, Hartmann A, Schmitt J, et al.European multidisciplinary consensus statement on the use and monitoring of metal-on-metal bearings for total hip replacement and hip resurfacing.Orthop Traumatol Surg Res. 2013;99(3):263-71. doi:10.1016/j.otsr.2013.01.005
Nam D, Nunley RM, Ruh EL, et al.Short-term results of Birmingham hip resurfacing in the United States.Orthopedics. 2015;38(8):e715-21. doi:10.3928/01477447-20150804-60
Gaillard EB, Gaillard MD, Gross TP.Interventions for improving hip resurfacing outcomes in women: a high-volume, retrospective study.J Arthroplasty. 2017;32(11):3404-11. doi:10.1016/j.arth.2017.06.003
Kahlenberg CA, Swarup I, Krell EC, Heinz N, Figgie MP.Causes of revision in young patients undergoing total hip arthroplasty.J Arthroplasty. 2019;34(7):1435-40. doi:10.1016/j.arth.2019.03.014
Gaillard-Campbell MD, Fowble C, Webb L, Gross TP.Hip resurfacing as an outpatient procedure: a comparison of overall cost and review of safety.Musculoskelet Surg. 2021;105(1):111-6. doi:10.1007/s12306-020-00637-z
Su EP, Ho H, Bhal V, et al.Results of the first U.S. FDA-approved hip resurfacing device at 10-year follow-up.J Bone Joint Surg Am. 2021;103(14):1303–11. doi:10.2106/JBJS.20.01886
Daniel J, Pradhan C, Ziaee H, Pynsent PB, McMinn DJ.Results of Birmingham hip resurfacing at 12 to 15 years: a single-surgeon series.Bone Joint J. 2014;96-B(10):1298–306. doi:10.1302/0301-620X.96B10.33695
American Academy of Orthopaedic Surgeons: OrthoInfo.Hip resurfacing.
Smith and Nephew.Statement regarding BHR system.
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