Areas of potential developments
The BIRMINGHAM HIP has demonstrated outstanding clinical performance. The key concerns clinically are with femoral neck fractures, which happen more in older, less active patients, and metal ion production, which is a problem for any metal on metal, or for that matter, any metal orthopaedic implant.
Reducing metal wear is important and has been part of further R&D supporting the BIRMINGHAM HIP for the entire decade that it has been used. Clinically, metal wear in the BIRMINGHAM HIP has been of limited problem, restricted mostly to implants that haven't been positioned correctly. Any development in an improved bearing surface needs to be clinically evaluated and compared to the outstanding results shown with the BIRMINGHAM HIP.
Femoral neck fractures have been shown to be related to patient selection, surgical technique and bone quality. Improving the implant design to work better with patients with poor bone quality is being undertaken now, but no obvious answers have been found. Therefore, potential improvements need to be studied clinically to see where they have benefits and risks. Surgeons who have been trained to use the BIRMINGHAM HIP System understand patient selection and the surgical technique issues.
Other resurfacing components have been introduced with changes to the basic BIRMINGHAM HIP design. None of these have yet demonstrated any clinical improvement. Because of its outstanding clinical results, the BIRMINGHAM HIP design has remained constant over the last decade and will remain constant for some time to come.
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