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Birmingham Hip Resurfacing (BHR)

What is hip resurfacing?

In traditional total hip replacement, both the head of the thigh bone (femoral head) and the damaged socket (acetabulum) are removed and replaced with an artificial implant.

Unlike total hip replacement, which removes all the bone within your ball and socket hip joint, hip resurfacing resurfaces just a few centimeters of bone, preserving more of your original joint. Hip resurfacing is an alternative to and less invasive than total hip replacement.

The Birmingham hip resurfacing procedure refers to a hip resurfacing operation using the Birmingham Hip Resurfacing implant, manufactured by Smith and Nephew, Inc.

The Birmingham hip resurfacing implant consists of two pieces, a femoral component and an acetabular component. Both pieces are made of an alloy of cobalt-chromium, one of the most durable metals used in artificial implants today. The acetabular, or socket, component is implanted with a press-fit technique. The roughened, porous, outer surface allows for bone ingrowth when implanted. The femoral component consists of a rounded surface that overlays the prepared femoral head. There is a short stem measuring approximately that allows the implant to be inserted in the proper orientation and alignment.

The Birmingham hip resurfacing implant is the most widely used in the world today. Therefore, it has the longest follow up data and most implantations of any hip resurfacing implant available. It is referred to as the “gold standard” of hip resurfacing implants. Due to the stellar performance of the Birmingham Hip Resurfacing to date, it is difficult to improve upon it in its current form.

Hip resurfacing is a safe and effective metal-on-metal hip implant system approved by the FDA in 2006. A 2021 study in the Journal Arthroscopy reports that the Birmingham Hip Resurfacing implants have a high survival rate with a 10-year survival rate of 95.9% and 15-year survival rate of 93.8%. Another study reports that 80% of patients were able to return to sports in 6-12 months after hip resurfacing.

  • The Birmingham Hip Resurfacing is designed to preserve as much of the patient’s natural bone as possible, making it a popular option for younger patients who may require additional hip surgeries later in life.
  • Birmingham Hip Resurfacing can allow for greater range of motion and improved stability compared to traditional hip replacement procedures due to a larger ball that is less likely to dislocate.
  • Significantly less blood loss than total hip replacement
  • Shorter recovery and earlier restoration of normal activities
  • Return to high-level sports including running
  • Excellent implant survivorship and functional outcomes
  • Metal on metal eliminates issue of wear on the implants
  • Complication and revision rates are not significantly different than a total hip replacement
  • Hip resurfacing restores near normal hip function, walking speed and gait

Hip resurfacing is intended for active patients suffering from hip pain due to non-inflammatory arthritis (degenerative joint disease) such as osteoarthritis, traumatic arthritis, avascular necrosis, or dysplasia/DDH, or inflammatory arthritis such as rheumatoid arthritis.

Furthermore, hip resurfacing is intended for larger-framed patients (often, but not always men) with strong, healthy bones. Patients that are older, female, smaller-framed, with weaker or damaged bones are not ideal candidates.

Birmingham hip resurfacing is typically recommended for younger and middle aged, active patients who have hip arthritis and want to maintain a high level of activity. It may also be a good option for patients who have had previous hip surgeries and have less bone to work with. To find out if Birmingham hip resurfacing is a good option for you, you must undergo a complete orthopedic evaluation from your LALL Orthopedics + hip surgeon.

Birmingham hip resurfacing is not recommended for people with osteoporosis or kidney disease, a suppressed immune system, or those who have metal sensitivities, and is not for people of child bearing age.

The hip specialists at LALL Orthopedics + perform Birmingham hip resurfacing from both the traditional posterior approach as well as the modern anterior approach. The posterior approach is the mainstay of treatment for most young adult males, however, select individuals with a specific body type are candidates for the modern direct anterior approach invented and developed by the expert team at LALL Orthopedics +. To find out if you are a candidate for either surgical approach, and to get you back to doing what you love, schedule a consultation today.

Birmingham hip resurfacing surgery is technologically advanced procedures performed by only a few surgeons worldwide given its long learning curve. Dr Lall performs navigated Birmingham Hip Resurfacing surgery via both the direct anterior and posterolateral approaches. A comprehensive evaluation by your orthopedic surgeon at LALL Orthopedics + will help you determine if you are a good candidate for hip resurfacing.

Dr. Ajay C. Lall is a former dual sport NCAA collegiate athlete (football and track & field), American board certified, triple fellowship-trained expert orthopedic surgeon who specializes in hip arthroscopy, robotic hip replacement and cutting-edge regenerative medicine such as platelet-rich plasma (PRP) and Stem-Cell therapy. He treats non-athletes and athletes at all levels of play from collegiate to professional to the Olympic level. Dr. Lall is a world-renowned orthopedic surgeon who cares for all patients like family. Contact LALL Orthopedics + to schedule a consultation, receive the correct diagnosis, and undergo state-of-the-art treatment options.

At a Glance

Ajay C. Lall, MD, MS, FAAOS

  • Board Certified – Orthopedic Surgery
  • Triple Fellowship Trained
  • Performs over 750 Surgeries Per Year
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