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Sticky PostingsThursday, June 28. 2007Wednesday, June 27. 2007Hip Resurfacing Article
Hip resurfacing is very near and dear to my heart and hip -
left hip to be exact. I am the proud owner of a
BHR (Birmingham Hip Resurfacing) that I received in March 2006.
My left hip had osteoarthritis for about ten years. My activities during those ten years began to decrease until my main recreation was sitting in my comfy, recliner chair. Having a bone on bone hip joint will bring your life to a complete standstill. Young or old, male or female - bone on bone pain can not be ignored. The pain will be present when you walk, stand, sit and even when you try to sleep. Sleep is impossible without pain killers as is most of your life.
In the past there has been only one solution to replace a painful, arthritic hip, a total hip replacement or THR. A THR meant that part of your femur bone would be cut off and drilled to accept a long stem ball replacement device that is pounded into what is left of your femur bone. Then if you ever need a revision in the future, what is left of your femur bone must be broken apart to remove the old stem.
A Hip Resurfacing with a BHR is bone conserving. The top ball of your femur bone is shaped to accept a cap that protects the femur. Then a cup is placed in your acetabulum as a bearing for the cap on your femur. This makes a metal on metal bearing that protects the painful old hip joint. If a revision is ever required in the future, the complete femur bone is still in place to allow a THR.
Hip resurfacing, unlike the old fashioned THR of the past, requires no restrictions to your activities. There is almost no chance of dislocation. Many athletes have had hip resurfacings and returned to the sports they love. If you or someone you know has a painful hip that needs to be replaced, be sure to learn about Hip Resurfacing before accepting an old fashioned THR. The FDA approved Birmingham Hip Resurfacing in the US last May 2006. Over 60,000 people world wide have BHR's and many more are learning about the new procedure. Doctors overseas have been performing hip resurfacing for almost fifteen years. Katie Ellis received her BHR in 1991 from Mr. McMinn the inventor of the BHR in the UK. The BHR approved by the FDA in May of 2006 is quite different than the older, hemi-resurfacing of the past. Hemi-resurfacing did not place a cup in the acetabulum of the hip, it only placed a cap on the femur bone and this resulted in a metal on bone joint that often became painful and required a revision.
If you are young and active, be sure to ask your doctor about hip resurfacing. If he/she does not seem to know about the new option, find a doctor in your area that does hip resurfacing. There have been many active people in their late sixties and even seventies that have had hip resurfacing. Be sure to ask questions of your doctor and do research so you don't end up with an old fashioned small ball THR that will restrict your activities and increase the possibility of a dislocation.
Monday, June 25. 2007Current Trends in Knee ArthroplastyCurrent Trends in Knee Arthroplasty: What should the patient know?
Barry J. Waldman MD, Esther A. Schaftel CRNP
(Thank You to Dr. Waldman for submitting this article to Hip Resurfacing News)
An Arthritis Epidemic
Unfortunately, there is an epidemic of knee arthritis in the United States. The American Academy of Orthopaedic Surgeons, estimates that between 2006 and 2030, the number of knee implants performed in the United States will increase from 300,000 a year to nearly 3.5 million. Even more concerning, the average age of knee implant patients gets younger each year1. It is not unusual for patients as young as 40 to experience severe knee arthritis and require knee implant surgery. Women account for about 60% of patients who need a knee implant - a proportion that has remained steady for the past few decades.3
Because the market for knee implants is growing so rapidly, there is intense competition between manufactures of implants for future business. Orthopaedic implant manufactures are working hard to convince surgeons and consumers that their knee products are superior to their competitor’s products. Because knee implants are very similar to one another, manufacturers have begun to market directly to consumers to increase their brand recognition and steer patients to their implants.
Implant Manufacturers
The four major manufactures are Zimmer, Stryker, DePuy (a division of Johnson and Johnson) and Biomet. All have very similar implants that work extremely well if they are implanted correctly. This has forced many of them to differentiate themselves using some unproved claims. Recently, Zimmer has been marketing a “gender-specific knee”, targeted at women. It claims that it has designed "a total knee system with the women in mind".3 In response, Stryker has asserted that their "design closely matches the anatomy of a female knee"3 and Biomet Inc. states the differences between sexes are not enough to warrant a difference in designs.3
DePuy has advocated a rotating platform knee that “bends and rotates.” to better match natural anatomy. While, these designs may have some benefit, there is no long-term data proving that they are any better than any other modern design. Differences in patient anatomy have long been recognized and incorporated into knee designs. These differences have far more to do with the patients overall size, not their gender or race.
Additionally, these newer implants may have some detrimental effect that isn’t obvious today, but will become apparent some time in the future. Because knee replacements are so durable and work so well for most people, it will take many decades to sort out the effect of new designs. To further confuse patients, hospital and doctors have begun to advertise directly through local media and the internet. Many claims made are not reviewed by other doctors and may be somewhat exaggerated.
Surgeon and hospital advertising often focuses on “minimally invasive” procedures. While a smaller incision can be beneficial, there is no agreement amongst surgeons as to the best methods to use. Some of these techniques have a higher complication rate and may cause more problems then they help.4
Advice to Patients
With the barrage of questionable information contained in advertising and on the internet, what can a patient do to obtain the best possible knee? Multiple studies have shown that the overall success in knee replacement can be traced to the surgeon and the team that cares for the patient during and after surgery. Surgeons and centers that do large numbers of implants have more success, on the average, than surgeons who do this type of surgery less often. When considering a doctor, it’s important to ask how many operations of this type they do each year and what their personal outcomes are. The hospital they use should have a dedicated joint center and do a large number of joint replacements each year. It is also important to find a physician that responds in a timely manner to phone calls and patient requests.
Almost all of the knee implants available today are the result of years of research and should offer excellent functional performance and longevity.1 Patients should be able to reap the benefits of any TKA with the right surgeon with the right supportive team. Try to view all the advertising and hype with skepticism and you won’t be fooled by unsubstantiated claims. It is far more important for patients to find a doctor that they feel comfortable with and that they can discuss their concerns with, rather than worry about the implant used.
References
Monday, June 25. 2007Hip Resurfacing Movie in Graphic FormMonday, June 25. 2007Live Webcast of Hip Resurfacing Surgery
Live Webcast of Hip Resurfacing Operation
Vivid webcast of real surgery from Lake Forest University Baptist Medical Center. Replay of Birmingham Hip Resurfacing Alternative to Standard Total Hip Replacement April 17, 2007 at 5:00 PM EDT (21:00 UTC) From Wake Forest University Baptist Medical Center, Winston-Salem, NC WINSTON-SALEM, N.C. – Wake Forest University Baptist Medical Center is the first hospital in the Triad to offer a new type of hip surgery that is an alternative to standard total hip replacement. Approved by the Food and Drug Administration in May 2006, the hip resurfacing procedure is designed for younger patients who want to remain physically active after hip replacement surgery. On Tuesday, April 17, at 5 p.m. EDT, Wake Forest Baptist will host a live webcast of the Birmingham hip resurfacing procedure, featuring Riyaz Jinnah, M.D., performing the surgery and William Ward, M.D., moderating the event. VIEW WEBCAST Monday, June 25. 2007Age Chart of Hip Resurfacing Patients
Age Chart of Hip Resurfacing Patients
List and chart of hip resurfacing patient's ages. This chart is a representation of the hip resurfacing patients that use the Yahoo Surface Hippy Discussion Board. READ MORE Monday, June 25. 2007Acetabular Bone Loss by Dr. Vijay C. Bose
Acetabular Bone Loss by Dr. Vijay C. Bose
...The acetabular size is the most important factor which determines the choice of femoral head size in resurfacing and one never removes more acetabular bone in hip resurfacings. In other words if I would be performing a conventional hip replacement on a given patient instead of resurfacing, I would be using precisely the same size acetabular component in both the surgeries. I would go as far as saying that if we are taking out more acetabular bone in resurfacing than in conventional hip replacement , then in my opinion there is no role for resurfacing and it must be discontinued immediately. Acetabular conservation is as important if not more than femoral bone conservation and all resurfacing surgeons recognize and acknowledge this fact. The ability to put large heads in resurfacing stems from the fact that thin shelled acetabular components are possible with the modern metal on metal bearings. However when one uses polyethylene it has to have a large thickness ,which in turn reduces the femoral head diameter , (assuming the acetabular outer shell diameter remains the same). The same argument holds true for ceramic on ceramic bearing to a lesser extent and therefore slightly large femoral head sizes than metal on poly is possible. However an anatomical size is currently possible only with metal on metal bearings... READ MORE  Dr. Bose of Incia Sunday, June 24. 2007 |
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