Hip Resurfacing News

Welcome to Hip Resurfacing News

Hip Resurfacing News features up to date news about hip resurfacing, FDA approved devices, personal hip stories, experienced surgeons, video interviews and press releases. 

Hip Resurfacing came of age in the United States when the FDA approved the Birmingham Hip Resurfacing Device in May 2006. Since then the FDA has approved the Cormet Hip Resurfacing Device and the Wright C+ Device.  Orthopedic surgeons have been performing hip resurfacing surgeries since 1997 overseas. More than 140,000 people world wide have received hip resurfacings.

Looking for more information about Hip Resurfacing? Visit the

Surface Hippy Website - A Patient to Patient Guide to Hip Resurfacing


Patricia Walter - Owner/Webmaster of Hip Resurfacing News and Surface Hippy Guide to Hip Resurfacing

All The Threes - Mr McMinn Reaches 3333rd BHR Milestone

24th January 2012

On Tuesday, Mr McMinn reached a momentous milestone in his surgical career – implanting his 3,333rd Birmingham Hip Resurfacing. To mark the occasion, Mr McMinn invited colleagues from The McMinn Centre, Smith & Nephew and The BMI Edgbaston Hospital for an impromptu shindig at Bindles Brasserie in Worcester.

"I was so thrilled and surprised to reach this landmark number, I just had to go out and celebrate with colleagues who have made this all possible,” Mr McMinn commented. “The fact that my patients are doing so well and that the BHR has a 97% success rate at 14 + years in my practice, is a tremendous reward for everyone involved in this development."

The news comes at a crucial juncture as more and more patients are demanding highly experienced surgeons to perform their hip procedures. Before dinner, Mr McMinn gave a short presentation about the history and success of the BHR and the future of hip arthroplasty.

The milestone precedes another exciting occasion on the 2012 calendar – the 15th Year Anniversary of the BHR, which we will be reporting on this summer.

The Awful pain

It was a decade ago when I came from work during the evening and was so tired that I went straight to bed. During the early morning hour like around 3AM I woke up and felt a sharp pain around the right side of my pelvis area. I waited a day to see if it is just a minor pain however the pain increased even more. So I visited a orthopedic surgeon at 2500 N Van Dorn St Alexandria VA who gave me a pain medicine after taking an x-ray. Which did not help at all, so instead I went to see my family doctor who sent me to a neurologist at 610 Carlin Spring Rd Arlington VA who gave me the steroid tablets for the pain. My biggest mistake was due to the fact I did not have the health insurance I should have gone to the ER for an evaluation and might have saved my hip from the further detrition of the hip infection; but instead I wasted several days by visiting different doctors who all of them gave me the wrong treatment. After a week I was in a extreme pain and was not able to stand from my bed. My family called the ambulance and was taken to the Alexandria Hospital where the orthopedic surgeon on duty Dr.Anuj Gupta performed several test including a cat scan. This is where he detected that I have an infection in my right hip. Before the surgery the anesthesia surgeon questioned me about any kind of allergic reactions. I told him that I have the severe allergic with the iodine and shellfish. The next morning Dr.Anuj Gupta performed a surgical procedure to clean out the infection from my right hip. He used Contrast-Dye during my surgical procedure that caused the severe complication and I almost lost my life. After the surgery he had told me that I would be looking forward for a hip replacement in the near future.

January 20, 2012

...Andrew Lloyd Webber feels like a young man once again after undergoing hip replacement surgery.

The multi-millionaire composer has revealed he underwent the procedure a few weeks ago and has made a full recovery.

Lord Lloyd-Webber, 63, said: "I feel so much better. The best thing is that now I can exercise again, I can go swimming, which I love."

...Lord Lloyd-Webber had a hip resurfacing, which replaces diseased or damaged surfaces in the hip joint with metal implants.

It is designed to tackle arthritis - where joint cartilage is worn away, leaving bone rubbing on bone, which causes severe pain.

Less bone is removed for hip resurfacing, making it easier to repeat the operation or to have a total hip replacement in later years...

13th January 2012

He has twice been Mr Universe and has played the tough guy in a variety of action movies, but when Mike Mitchell was floored by a hip injury it was Birmingham surgeon Derek McMinn who came to the rescue.

Fitness icon "Iron Mike", who appeared as a stuntman and action fighter in smash hit films Braveheart and Gladiator, had been suffering from severe osteoarthritis in his left hip but, true to his tough-guy image, had carried on regardless.

However, when the 56-year-old took a nasty fall while out on his yacht he found himself almost unable to walk and in danger of missing out on a new film he had just agreed to appear in.



As Mike contemplated surgery and a one year lay-off, he heard about Derek McMinn the inventor of the world-famous Birmingham Hip Resurfacing (BHR) treatment. From then on Mike’s story was heading towards a very happy ending.

"I was told a hip replacement would lay me up for at least a year so when I heard about the work done by Mr McMinn I just had to get in touch with him. The result of the operation was unbelievable – I was active and exercising within a month and back sailing a month after that," he explained.

Mike, who has also held the World Fitness Champion title five times, had his operation at BMI Edgbaston Hospital where he met up with Mr McMinn, the inventor of BHR.

He explained: "My whole life has been about finding the best. When I trained for Mr Universe I found the best trainer and the best nutritionist. When I knew I needed an operation I only wanted to deal with the best and in Mr McMinn I found a real world leader in the field."

Now back in the film studio, as well as taking part in sailing adventures such as sailing a yacht the 1,900 miles from Gibraltar to Turkey in storm force 10 conditions, Mike says he is "as good as new" and looking forward to his latest movie "Rose" being shown at the Cannes Film Festival next year.

Mr McMinn, affectionately known in the medical world as the "Father of Modern Hip Resurfacing" - that even he was amazed at the speed of Mike's recovery.

"Even though Mike is a very strong man there wasn’t much he could do once the arthritis in his hip reached such a stage. It didn’t take me long to decide that the BHR was the perfect treatment for him and, judging by his impressive return to fitness, it would seem to have been the correct decision."

"One of my patient studies shows that 92% of male patients with one BHR return to playing sports after previously being sidelined by the injury while 62% return to playing impact sports like squash, judo and football."

Information from Dr. Bose at the Asian Regional Center for Hip Resurfacing

Introduction:

The Birmingham Mid Head Resection prosthesis is a recently developed hip prosthesis for patients who are keen on having metal on metal hip resurfacing but do not have enough bone stock in their femoral head to accept a resurfacing implant. The BMHR, by its resection level is suitable for these patients thereby opening an avenue for these patients to benefit from the resurfacing technology.

Asian regional center for hip resurfacing is the only center in Asia where currently BMHR surgeries are being performed. Dr. Vijay C. Bose of ARCH is one of the very few surgeons in the world to perform this surgery.

 

Concept:

It was increasingly becoming obvious that some younger active patients were not candidates for resurfacing due to some technical issues. In these patients only a stemmed component was possible by removing bone stalk. The new BMHR –Birmingham Mid Head Resection device is the ideal prosthesis for this patient group as it retains almost all the advantages of resurfacing. It is feasible even in patients who have large cysts or other structural abnormalities of the proximal femur.

 

The BMHR Prosthesis:

The acetabular component of the Birmingham Mid Head Resection prosthesis is the same as that of the BHR prosthesis. The femoral side is constituted by two modular components - a stout stem with a fusicone contour in the proximal portion and anti – rotation splines at the distal end . The special BMHR head goes over the taper adapter present at the top.

 

Current Indications

The Birmingham Mid Head Resection Prosthesis( BMHR) is used in the following clinical conditions -

• Avascular necrosis of the femoral head with significant bone loss.
• Femoral neck deformity (Valgus neck, Femoral Head Retroversion)
• When the cysts in the femoral neck are large, hip resurfacing cannot be performed. The BMHR is the choice of implant for such patients.
• This implant is suitable for abnormal pathologies like Perthes and SUFE.

Benefits and comparison:

• The BMHR prosthesis does not violate the femoral canal. Hence it can be revised to total hip replacement if required at a later stage.
• Loading at the head and neck junction is similar to BHR hence the benefits of BHR prosthesis also applies to the BMHR.
• Recent finite element analysis studies have proven that the load distribution in BHR is very similar to that of BMHR.

Changing a tire at two weeks post op is not a good idea. We often forget that we are healing after major surgery and do things without thinking. Please think before doing any strenuous activities shortly after surgery. I think the people that do "really dumb things" realize it very quickly! Anyone that had major surgery and wants to do heavy work any time within the first six weeks is going to pay a big price including a possible revision due to a femur neck fracture or component movement. No matter how much you warn people, they just can't understand the impact such major surgery has on their bodies. You can't force your body to heal or be strong after it has been sliced and diced. I would caution people to be careful even beyond the six weeks up to six month period. Most surgeons will let patients do normal activities at six months, but warn that it takes a full year for the body to heal completely after a hip replacement. Why go through a recovery from major surgery and then take a chance on having a revision. Makes no sense, but neither do the actions of many people.

Please think before acting. Get help when you are faced with any problem that means you need to exert your new hip to lift a lot of weight. One man recently posted that he fixed a flat tire when he had surgery two weeks before. Fixing a flat tire to be on time to an appointment is not as important as going thru another surgery for a revision because you fractured your femur neck. Please think before performing strenuous activities. There is nothing more important than your own health if you want to continue to be active and be there for your family.

Often parents are tempted to lift their children after hip surgery. Lifting could mean that you are going to crack a femur, dislocate your hip or move an acetabular cup component. Any injury to the femur bone, surrounding tissue or muscles could result in a revision. Each revision surgery after your first hip replacement becomes more difficult than the original surgery.

THR Revision Information

We need to remember that the time to recovery and let our bodies heal is actually very small when compared to a lifetime. Healing and becoming strong again will allow you to be active with your children once again. They will understand that you are healing and will look forward to the time when you are able to be a full time parent without pain.

For Immediate Release: October 13, 2010 Media Inquiries: Karen Riley, 301-796-4674, karen.riley@fda.hhs.gov Consumer Inquiries: 888-INFO-FDA

   FDA: Possible increased risk of thigh bone fracture with bisphosphonates Labeling change adds warning about possible risks of long-term use of osteoporosis drugs  

The U.S. Food and Drug Administration today warned patients and health care providers about the possible risk of atypical thigh bone (femoral) fracture in patients who take bisphosphonates, a class of drugs used to prevent and treat osteoporosis. A labeling change and Medication Guide will reflect this risk.

Bisphosphonates inhibit the loss of bone mass in people with osteoporosis. Bisphosphonates have been shown to reduce the rate of osteoporotic fractures -- fractures that can result in pain, hospitalization, and surgery-- in people with osteoporosis. While it is not clear whether bisphosphonates are the cause, atypical femur fractures, a rare but serious type of thigh bone fracture, have been predominantly reported in patients taking bisphosphonates. The optimal duration of bisphosphonate use for osteoporosis is unknown, and the FDA is highlighting this uncertainty because these fractures may be related to use of bisphosphonates for longer than five years.

The labeling changes and Medication Guide will affect only those bisphosphonates approved for osteoporosis, including oral bisphosphonates such as Fosamax, Fosamax Plus D, Actonel, Actonel with Calcium, Boniva, Atelvia, and their generic products, as well as injectable bisphosphonates such as Reclast and Boniva.

Labeling changes and the Medication Guide will not apply to bisphosphonates used for Paget's disease or cancer/hypercalcemia such as Didronel, Zometa, Skelid, and their generic products.

"The FDA is continuing to evaluate data about the safety and effectiveness of bisphosphonates when used long-term for osteoporosis treatment," said RADM Sandra Kweder, M.D., deputy director, Office of New Drugs in the FDA's Center for Drug Evaluation and Research. "In the interim, it's important for patients and health care professionals to have all the safety information available when determining the best course of treatment for osteoporosis."

Today's warning follows a March 10, 2010, Drug Safety Communication announcing the FDA's ongoing safety review of bisphosphonate use and the occurrence of atypical femur fractures. The FDA has since reviewed all available data on bisphosphonate use, including data summarized in the American Society for Bone Mineral Research Task Force report. The report recommended additional product labeling, better identification and tracking of patients experiencing these breaks, and more research to determine whether and how these drugs cause the serious but uncommon fractures.

Based on the FDA's review, the Warnings and Precautions section of all bisphosphonate products for osteoporosis will be revised, and the FDA will require the inclusion of a Medication Guide to better inform patients of the possible increased fracture risk.

The FDA recommends that health care professionals be aware of the possible risk in patients taking bisphosphonates and consider periodic reevaluation of the need for continued bisphosphonate therapy for patients who have been on bisphosphonates for longer than five years.

Patients taking bisphosphonates for osteoporosis should not stop using their medication unless told to do so by their health care professional. Those taking bisphosphonates also should report any new thigh or groin pain to their health care provider and be evaluated for a possible femur fracture. Patients and health care professionals should report side effects with the use of bisphosphonates to the FDA's MedWatch Adverse Event Reporting program at www.fda.gov/MedWatch or by calling (800) 332-1088.

For more information: FDA Drug Safety Communication Consumer Update: Possible Fracture Risk With Osteoporosis Drugs

A member of my Hip Talk Discussion Group http://www.surfacehippy.info/hiptalk/ asked why it took surgeons so long to learn how important the angle of the acetabular cup angle is during hip resurfacing surgery. Incorrect placement of the acetabular cup has caused many failures of hip resurfacing resulting in revisions to total hip replacements.

My answer to that questions of why it takes so long to learn if a hip device and/or surgical technique is successful is if anyone has worked in the engineering or design field, they will realize that usually the original design of a product or machine is never what the final design turns out to be. We are not machines that can determine perfect designs for anything. There are always unknowns. If you think about many things in our lives, they are always under constant change and updates. Car models are often changing, TVs are changing, cell phones, computers, etc. are constantly in change. Software for computers are always updating and changing. Athletes are always changing techniques to improve their skills. Musicians are always practicing to improve their skills. Medicine and joint replacement is not any different. Engineers are trying to design a device to replace a human joint while doctors are trying to place that foreign object in our bodies to act as the original equipment. This is not an easy task. There have been thousands of designs of hip devices over the years. The metals or plastics continue to change, the metallurgy changes, and the designs of the components change. There is nothing static about designs, they are constantly changing.

I learned from the many hip resurfacing conferences I attended, that it takes time for doctors to learn how the devices are actually working in patients. Typically it takes about 3 to 4 years for them to start to see trends about how the device has acted and how the bone growth has attached to the components. It takes time for the results to become statistics. So with any device, the wait period takes time and often by then, there has been a change in the device. So there are few devices of the same design left after a few years to compare results.

It simply is very difficult tracking the new devices and their results right after their implant. Many of the top experienced surgeons were placing the actabular cups at a good angle early on. They knew instinctively that the acetabular cup should be in a certain position to work well. I have always said and heard surgeons say the same thing, that surgical skill is more than a skill or learned process, it is also an art. It is like the great athletes that instinctively know what to do. They do learn and practice, but have a God given skill that places them way above many other athletes. The same is true with the really top surgeons. If you think about sports or activities you are personally really good at, you are not looking at the educational videos or books to learn how to throw a ball, play an instrument or type on a computer. Those with really good skills are able to do it almost without thinking. That's is the way it is with the top surgeons. They had an instinct about how things should work and were very successful. McMinn of the UK is doing that all the time as he develops devices. Many of the other top surgeons have helped develop hip devices and many of the surgical instruments to help place hip devices. A recent example of one is with Dr. Kusuma in Columbus. http://www.surfacehippy.info/observinglivesurgery.php  He wanted a better way to insure his placement of a BHR was correct. He developed a template system which no other surgeon had done before. Smith & Nephew are thinking of having him teach it to new surgeons.

There is a great deal of constant change with any hip device or any man made mechanical device. Designs keep changing and hopefully for the better. Skills and instruments to place joint devices keep changing and hopefully for the better. It is very complex and just takes time to develop excellent devices and how to place them exactly. The orthopedic surgeons keep track of their series of hip resurfacings and the National Directories  http://www.surfacehippy.info/nationalregistries.php keep track of hip resurfacing patients.  It takes time for all the statistics and results to accumulate and become tools to help learn about a hip device and a specific surgical technique.

Pat

I wanted to take the time out to thank you so much for your informative web site.

A year ago, I was diagnosed with Osteoarthritis and was told that I needed a THR. Well, as a young 45 active male use to being active until the pain took over, I scheduled the THR.

However, when I started researching I came across your site www.surfacehippy.info . That is when I found Dr. Mont in Baltimore, a 2 hr drive up the road. Needless to say, I did my due diligence and watched all of the interview videos and read numerous patient stories. All from your site.

Well, after going through Dr. Mont’s physical therapy program, I made the decision that my osteoarthritis was progressing for the worse and that surgery was needed. So in late August, the surgery was done.

I am happy to report that the day after surgery I took no pain meds. Simply stated, the pain prior to surgery far exceeded the surgical pain. More important, after my 5 week appointment at Dr. Mont’s office, I was cleared for Physical Therapy. It was 3 weeks after the therapy that I was back in the woods bow hunting.

I thank you for your efforts and will keep up with your site for new and breaking progress in this field of study.

Respectfully,

Dale Weaver