Bone gets denser when regularly loaded. If left unloaded, the bone atrophies, becoming less dense. Because a total hip is fixed about a third of the way down from the top of the remaining leg bone, the upper part of the leg bone loses density over time. A BIRMINGHAM HIP
◊ loads the upper leg bone more like the way that it is loaded normally.
This is demonstrated in studies showing bone density improving from the pre-operated state(1) . These studies show a decrease in the bone density of THRs, which has been demonstrated in many other studies.

| Box plots of the BMD ratio in Gruen zone1(a) and Gruen zone 7(b). The median value is represented by the central, horizontal line. The 75% and 25% values are reprsented by the upper and lower borders of the box and the 90% and 10% value by the extensions of the vertical lines. |