BHR vs THR

Hi All,

I”m currently scheduled for a right THR on Jan 16, 2018.  But I was talking to someone at work that had the BHR instead of the THR and recommended it as an alternative at the Cleveland clinic.  Anyone have the Birmingham Hip Resurfacing instead of THR  or done research?   Have thoughts?

2 thoughts on “BHR vs THR

  1. Hi LJay – I have a BHR and a THR and I have done a lot of research over the last 4 years. My first recommendation is to explore the website “Surfacehippy.com” and look at Mr McMinn’s own website because he invented the procedure. For me, BHR was a no-brainer but I was about at the limit of the envelope for age and bone quality. Since then (nearly 3 years ago) the BHR device has been limited to males and with a minimum size of 48mm (me) by the manufacturer. This has not meant the end of resurfacing, though, as other devices are available and small women can still be treated by experienced surgeons, of which there are a couple of handfuls in the US and somewhat fewer in the UK.
    In practice, there is little difference in the short-term results as far as I can see. My BHR was only a couple of months old when I started jogging carefully but it took about a year to feel completely confident running fast. My THR is only 5 months old and jogging recommended at 6 weeks because I had no femoral head to worry about breaking off (the operation saw to that, unfortunately) and I have already done lots of running, walking, cycling and climbing as my recent post shows. There is still some pain in this leg though, but a THR from scratch, rather than a failed BHR op, would be an easier operation with less soft-tissue disturbance.
    Technology: BHR is metal on metal, newer devices are metal on polyethylene. There is a risk of reaction to the chrome or cobalt contained in the steel, but a very small risk. Lifespan of the bearing is at least 20 years if fitted properly ie Dr Gross at Cleveland Clinic or Derek McMinn/Ronan Treacy in Birmingham, UK. Modern resurfacing using polythene can have the polythene liner replaced if it wears (Dr Pritchett). THR is based on ceramic, mine is ceramic on ceramic but the trend is for ceramic on polythene, again the liner should be replaceable if it wears. Ceramic will not wear but used to shatter, apparently this has been overcome with new materials.
    Disadvantages: THR involves a metal stem inside the femur, normal loading of the femur encourages bone growth but the load/stress is shielded by the stem so bone will tend to lose density (the opposite happens with resurfacing) and to me this is the biggest disadvantage to THR, and must be a significant concern to younger people faced with the decision.
    Resurfacing will always be more expensive and less likely to be accepted by insurance companies, and MoM currently has a very bad press due to previous faulty devices and poorly trained surgeons.

    Hope this helps,

    Pete

  2. Thanks for the insight Pete! I heard the recovery overall is shorter with the THR. I did some research and it seems that I may not be a candidate as I’m not a large male ( 5’8 and 180 lbs) also my issues come AVN. Although my coworker had AVN has the BHR and sings nothing but praises.

    I have a call in for a consultation so I see what they have to say. That combined with insurance coverage may make the decision for me.

    Thanks a bunch for the info.

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