Direct Anterior Birmingham Hip Resurfacing: Surgical Technique

Abstract

Birmingham hip resurfacing (BHR) arthroplasty is an established alternative to total hip arthroplasty for end-stage osteoarthritis, specifically in the younger male patient population who wish to return to high-performance physical activity. Traditionally, this procedure has been performed via the posterolateral approach mainly due to the design of intraoperative equipment utilized for femoral component placement. In other words, no current intraoperative equipment has been designed to perform the BHR via any approach other than the posterolateral approach. Recent literature has shown numerous advantages to direct anterior approach arthroplasty, among total hip arthroplasty patients, such as shorter recovery times, less pain, and improved overall functional outcomes. This technique paper aims to highlight a step-by-step approach of achieving the benefits of direct anterior approach arthroplasty in the patients indicated for BHR. A novel guide-pin technique has been developed to account for lack of intraoperative equipment, with pearls and pitfalls explained in detail. We hope this technique will help to guide surgeons in performing the direct anterior BHR with safety and success thereby maximizing patient outcomes.