Birmingham Mid Head Resection (BMHR) :
Birmingham Mid Head Resection, BMHR, (MMT Ltd, Birmingham, United Kingdom, now Smith and Nephew Orthopaedics Ltd, Bromsgrove, United Kingdom) was developed.
Illustration showing the three types of prostheses implanted in patients with femoral head avascular necrosis.
Birmingham Mid Head Resection Prosthesis (BMHR) X-rays
Birmingham Mid Head Resection prosthesis is an advancement in the BHR and will expand the indications for hip resurfacing surgery. Birmingham Mid Head Resection prosthesis (BMHR) helps advanced aged patients to have Birmingham Hip Resurfacing.
The BMHR has specifically been designed for patients who have weaker bone in the head of the femur. In the BMHR more of the weak bone is resected and is replaced with metal. This will dramatically increase the range of patients who can have this surgery.X-ray wise it looks almost like the BHR but the amount of bone removed is more. Thus the risk of fracture in post-op is reduced or eliminated for borderline patients.
Indications for the Mid Head Resection Prosthesis
Developmental dysplasia with shortened femoral head-neck segment
Extensive avascular necrosis of the femoral head
Large cysts of the femoral head
Abnormalities through Epiphyseolyses and Morbus Perthes (femoral head necrosis of children)
Reduction of bone substance due to arthroses
Marked bone involution through inactivity but with regression potential
X-Ray of BMHR in place
In cases of advanced arthrosis, a defect of the femoral head occurs which prevents the reliable anchoring of the resurfacing component. The titanium stem grows into the healthy part of the femoral head and neck, and is a safe base for the head component.
Resurfacing is only advisable when the stability of the bone and the shape of the femoral head offer sufficient support for the prosthesis. With healthy and active patients who do not meet these requirements but who can benefit from a bone conserving process, the Mid Head Resection can be an alternative to a standard prosthesis.
With this prosthesis, the fixation of the femoral component depends less on the bone of the femoral head but more on the stability of a titanium stem with bone ingrowth in the femoral neck.
Those parts of the femoral head which have been destroyed by cysts, circulatory disorders, malformations or involution due to arthrosis are removed. A titanium stem adjusted to size is implanted into the healthy part of the femoral head and neck, which is fixed by bone ingrowth (combines with the bone) and strengthens the femoral neck. In this way the implant-bone compound can withstand bending and torque forces.
Through the use of this implant, an opening of the femoral medullary cavity can often be avoided by implanting a prosthesis stem. The advantage of resurfacing is retained
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What is the BMHR and Why do we need it?
For patients with osteonecrosis involving a larger volume of the femoral head, an uncemented short-stemmed prosthesis, the