BACKGROUND: We previously reported the 5-year results of the Birmingham Hip Resurfacing (BHR) implant. This study evaluates BHR survivorship as well as radiographic and clinical outcomes at long-term follow-up. METHODS: A total of 224 patients with contemporary indications, including 179 patients from the original study, were included in this analysis. Survivorship was calculated. Metal ion levels and radiographs were updated. Patient-reported outcomes (PROs) were compared with those for matched patients who had undergone total hip arthroplasty (THA). The mean follow-up was 14 years. RESULTS: Survivorship free from any revision and from aseptic revision was 96.0% and 97.4% at 15 years, respectively. Two patients had undergone revision since the original study. The median serum cobalt and chromium levels were 1.4 and 1.5 ppb, respectively. The PROs were similar to those for the THA cohort. Equal proportions of patients remained active
however, the BHR group trended toward more remaining highly active (p = 0.12). CONCLUSIONS: Although activity was similar to THA at long-term follow-up, the BHR implant remains an excellent option for the treatment of osteoarthritis in younger male patients. LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.