What are the Differences Between a Birmingham and Total Hip Replacements?

Hip resurfacing surgery, commonly known as a Birmingham Replacement is an alternative to Total Hip Replacement surgery in suitable patients. A Total Hip Replacement requires the upper portion of the femur bone to be removed and then replaced with a new artificial stem and head of femur. 

A Birmingham resurfacing requires the existing head of femur to be reshaped and capped with an artificial surface.

Both procedures require a cup to be placed in the original hip socket. Suitability for either type of replacement is decided upon by the patients anatomy, age, bone health and their surgeon.

Total Hip Replacement is a very successful procedure, proven over many years.  For patients with increased risk of hip fracture, those with poor quality of bone due to Osteoporosis or Avascular Necrosis and those who may not be able to have metal on metal bearings are better off with Total Joint Replacements. They also work well for older patients and the less active as wear and tear of the prosthesis will generally be less in these people. In the young and active, wear of the prosthesis can cause loosening and eventually the prosthesis to fail requiring revision surgery. This can become more difficult with subsequent revision, which can occur in a younger patients lifetime, as bone the stock usually diminishes. Because more bone is retained in a Birmingham Replacement, it can be more suitable for these patients.

Because Total Hip Replacements have been performed for a long period of time, the lifespan is well known. With normal wear and tear, hip replacements average about 15 years. Of course there is variance with this. Because the Birmingham prosthesis has been around for only around 10 years, it’s longevity is unknown. So far, they have shown a slightly higher failure rate in the first couple of years after implantation, but it is thought that once this period has passed the risk of failure is low. Because the Birmingham replacement is a metal on metal bearing it is felt that they will last a long time, around 20-30 years. Only time will tell if this is to be the case.