Hip Resurfacing News

Birmingham Hip Resurfacing:
Regaining the Ability to Walk

By Joyce A. Reed

[2]

Like many Americans in their 50’s, I suffer from various forms of osteoarthritis. For the past two years, the arthritis pain in my right hip gradually increased. One day in January 2007, I woke up in the morning and stepped out of bed placing my normal weight on my right leg. A sharp pain shot from my right foot to my hip, and I sat back down quickly.

I made an immediate appointment with my orthopedist, and he discovered that the cartilage in my right hip joint was gone! The joint surface was literally “bone-on-bone”. He told me that I needed hip replacement surgery. I tried to discuss other options with him, but he retorted, “You are not going to get out of this one!” I needed the surgery.

Knowing nothing about hip replacement surgery, I researched the surgery on the Internet and in issues of Arthritis Today© for answers to my many questions. I discovered a recently approved FDA surgery originally developed in Europe, Birmingham Hip Resurfacing.

Birmingham Hip Resurfacing [1] can be compared to capping your teeth instead of pulling your whole tooth and replacing it with an implant. The actual device is all metal consisting of chromium steel. It is simplistic in design being a socket and ball with an attached stem. Unlike the former hip replacement devices, the Birmingham does not have plastic parts that can easily fail. The Birmingham procedure has been used in Europe for a few decades, and one marathon runner reportedly is successfully running/walking on his/her Birmingham hip replacement for 10 after the surgery. S/he has placed 35 life-cycle-years of use on his/her hip. A life-cycle-year is how far a normal person walks in one year.

On the internet, I found Dr. Stephen Raterman of Tampa, Florida. Dr. Raterman was the closest orthopedic surgeon using the Birmingham system to my home. I called and made an appointment. While I waited for the appointment, I started using a cane to walk since the pain of placing any weight on my right leg became unbearable.

During my first appointment, Dr. Raterman and his staff were attentive, professional and friendly. They x-rayed my hip and found that the ball section of my right hip joint had completely collapsed. Dr. Raterman carefully explained the details of the surgery to my husband and me. He told us that he would try to perform the Birmingham Hip Resurfacing on me by grafting bone to buildup my collapsed socket. Once the surgery began, if he discovered that he could not graft enough bone to do the resurfacing then he would do a Birmingham Hip Replacement. The Hip Replacement uses the same device as is used in the Hip Resurfacing, but the stem on the ball is longer to give the Replacement the stability it needs to operate correctly. When I left his office, I was very comfortable about my upcoming surgery.

In early May 2007, I checked into the University Community Hospital at Fletcher in Tampa, Florida. The hospital staffs were friendly and helpful. They quickly and easily prepared me for my surgery. My husband remained with me until I was moved into surgery.

My surgery lasted about two hours. My husband was impressed with the electronic patient status monitor in the waiting room. The board gave detailed information about me to him concerning pre-operation, operation and post-operation status. I woke in the Recovery Room with only a mild sore feeling in my hip. While everyone was very concerned about my pain levels, I never really had any pain. The surgical scar was only about 12 inches long and very thin. If I regained my ability to walk, it was a small sacrifice to make. My husband joined me in the Recovery Room, and I was quickly moved to my hospital room.

The hospital nursing and therapy staff provided excellent and friendly care. The day following the surgery, my therapist got me out of bed and up on my feet. The pain in my right leg was gone! I continued therapy and was released two days after my surgery.

I walked with a walker while in the hospital and for approximately ten days after leaving the hospital. I then went directly to walking with a slight limp for another week. The limp gradually improved until I walked normally again!

I did have one obvious post-operative problem. How could I pass through Homeland Security checkpoints at airports if I had a large metal object inside of my leg? Dr. Raterman’s office solved this problem by issuing me a medical security card listing my name, date of operation and an illustration of the device. Homeland Security accepts the card in conjunction with my normal picture identification.

I believe that writers overuse the word miracle, but miracle is the only word that fits my Birmingham Hip Resurfacing experience. The surgery changed my life bringing me from someone who could barely walk with a cane to normal walking. I can now completely enjoy my life.

I cannot find the words to thank my doctors, especially Dr. Raterman, for performing this miracle. I also want to thank Arthritis Today© for publishing informative articles that led to my discovering the Birmingham Hip Resurfacing.

For further information concerning this new procedure, see www.birminghamHipResurfacing.com .

[1] Picture courtesy of Dr. Stephen Raterman

[2] Picture courtesy of Worley (Lee) Reed, Author’s Husband

Low-cost foreign care begins to take offBy Susan Deutschle Business First of Columbus Business First of Columbus Updated: 8:00 p.m. ET July 29, 2007

 

There's a quiet revolution slowly building momentum in the health-care industry that could potentially lower the cost of employer-sponsored medical plans over the next decade. A new phenomenon called medical tourism confirms that globalization is finally affecting the health-care industry.

 

A growing number of uninsured and under-insured medical patients are traveling to foreign countries for services and procedures that are significantly less expensive than what's charged by American hospitals and clinics. This new competition has some experts predicting that natural market forces will eventually cut costs here.

 

"I don't think medical tourism is a near-term solution to the health-care problem in America, but I do believe this won't be seen as a novelty in another five to 10 years," said Robert DeWitt, a health-care attorney with Columbus-based Squire Sanders & Dempsey LLP. "Employers could end up saving a lot of money once this catches on more."

 

It's called medical tourism because a patient can receive medical care while experiencing the excitement and adventure of traveling to an exotic locale - although critics are more likely to characterize it as an opportunity to have an operation and witness regime change at the same time...

 

..."The U.S. accounts for one-third of health-care spending globally, but ranks 37th in quality of care. That's not a hard record to beat," DeWitt said.

 

The potential market for medical tourism is staggering in light of the fact that more than 15 percent of Americans are uninsured, according to 2005 figures from the U.S. Census Bureau. That's almost 45 million prospective tourists from one country, and doesn't include the millions of underinsured people who have minimal coverage with high deductibles.

 

Josef Woodman, the author of a medical tourism guidebook, "Patients Beyond Borders," estimates that more than 150,000 Americans traveled to foreign countries for medical care last year. He expects that number to double in 2007.

 

Another author, David Hancock, who wrote "The Complete Medical Tourist," estimates global medical tourism will evolve into a $40 billion-a-year industry by 2010...

 

...Wall says that there isn't a lot of buzz yet about medical tourism among his health-care colleagues.

 

"But physicians certainly aren't immune to worrying about competition," Wall said.

 

Some employers and health plans are already offering attractive incentives to patients who accept treatment overseas, including cash rewards, first-class round-trip airfare and recuperative stays at luxury resorts. Blue Cross/Blue Shield of South Carolina, for example, now covers treatments provided by a hospital in Bangkok, Thailand.

 

DeWitt says that progressive American health-care organizations are looking at ways to engage in the concept.

 

"Some are expanding their operations to other countries, and others are trying to affiliate with foreign hospitals," DeWitt said.

 

There are still a lot of issues to be sorted out before medical tourism becomes mainstream, including legal matters such as liability and coordination of care for chronic cases.

 

"It's a major paradigm shift, that's for sure," Wall said.

 

© 2007 Business First of Columbus URL: http://www.msnbc.msn.com/id/20030999/

 

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DOWN THE LINE Mike DiGiovanna July 29, 2007

 

Shuey gets hip to a comeback

 

What seemed like a routine save, 1 1/3 scoreless innings to close a 6-3 victory over the Angels on June 30, was anything but for Orioles reliever Paul Shuey, who in the five years since his previous save had three hip surgeries, including a hip-replacement procedure that has not yet been approved in the U.S., three full seasons away from the big leagues and one retirement.

 

"You go through all the effort to get back, and then to get an opportunity like that … " said Shuey, the 36-year-old right-hander who last saved a game for the Dodgers in a 6-2 win over Florida on Aug. 22, 2002. "It was really nice."

 

Shuey, a pennant-drive acquisition from Cleveland in 2002, went 11-6 with a 3.43 earned-run average in 90 games for the Dodgers despite right hip pain — stemming from a 1999 injury and arthroscopic surgery — that grew severe by the end of 2003.

 

He had surgery to reattach the labrum in his hip and grind down several bone spurs that winter, but his condition worsened the following spring, and Shuey, one of the game's hardest throwers in Cleveland from 1994 to 2002, lost his velocity.

 

"If it's excruciating and you can throw 96 mph, that's one thing," Shuey said. "When the pain is that bad and you're throwing 87-90 mph and you're ineffective, you're not going to get away with much."

 

Shuey underwent another surgery to fill a hole in a bone where a large spur had been removed, and he missed the entire 2004 season. He went to spring training with the Indians in the spring of 2005, and his velocity — if that's what you want to call it — topped out at 82 mph.

 

"The big man upstairs," Shuey said, "was telling me I had to shut it down."

 

After a brief stint with Cleveland's double-A team, Shuey retired and considered a hip replacement.

 

His doctor advised a less-invasive procedure called hip resurfacing, in which a metal ball joint, socket and pelvis are inserted. "I basically have a big ball bearing in there instead of a hip joint," he said.

 

As soon as he got off crutches, Shuey began throwing without pain. He found his proper stride and mechanics. His fastball returned to the 91-mph range, and after working out for scouts, he landed a contract with the Orioles.

 

Shuey opened 2007 at triple-A Norfolk but was called up in June and is 0-1 with a 4.80 ERA in 15 games.

 

He sets off all sorts of bells and whistles when he goes through airport security, "but the arm is good," Shuey said. "I wouldn't be surprised to play a few more years."

 

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Hip Resurfacing Learning Curve for Surgeons

 

ORTHO Supersite News Wire (June 20, 2007)contained a link to an article from Orthopedics International 2007, 10:10, May 2007, which describes a study from Diane Back on the learning curve for correct placement of the femoral hip resurfacing components. Instead of the 10 to 20 cases expected it actually took from 50 to 60 cases for the surgeons studied to place the components where they wanted it (+/-5% of target). In the United States where orthopaedists begin practicing after completing fewer hip replacements than surgeons in the United Kingdom or Australia, "It actually means their learning curve may take them 10 years to get out of," Back said. She also recommends that surgeons just learning the procedure should tell patients they are at the beginning of their learning curve and have not done many of the procedures.

 

To see the full article, subscribe to ORTHO Supersite News Wire.

 

Information in the News Wire:

 

* Diane L. Back, FRCS, Ed Orth, can be reached at Guy's and St. Thomas Hospital National Health Service, Lambeth Palace Rd., London, SE17EH, England; +44-20-7188-4435 ; e-mail: diane.back@gstt.nhs.uk. She has no financial disclosures related to this presentation. * Back DL, Smith JD, Dalziel RE, et al. Establishing a learning curve for hip resurfacing. #130. Presented at the American Academy of Orthopaedic Surgeons 74th Annual Meeting. Feb. 14-18, 2007. San Diego.

What Items Will I Need At Home After Surgery?

 

Everyone has slightly different needs.  There are some basic items almost everyone needs and then there are things that some people want and others just don’t need.

 

Must Haves:

 

Crutches  - Normally crutches are supplied by the hospital.  I used elbow crutches and they are much easier to use than normal under the arm crutches.  Overseas hospitals use elbow crutches while US hospital still normally use old fashioned under the arm crutches.  If you have to be on crutches for a long time, I would suggest getting a pair of elbow crutches or at least a pair of the more modern underarm crutches available from many internet shopping stores.

 

Walker – some people that have bi-lateral surgery or special hip problems are required to use a walker.  Whether you use crutches or a walker is up to your orthopedic surgeon.

 

Cane – Canes are often used after a crutch is no longer needed.  A cane is a handy method of still having support if required.  People often get tired on long walks and find it easy to carry a cane with them to offer assistance.  A cane offers much less assistance than a crutch, but it does take weight off the operated leg. It is estimated that a cane will take almost 60% of the weight off the operated leg when used properly. A cane is used on the opposite side of the operated leg, is moved forward with the operated leg as it takes a step and planted about the same position in front of your body as your step.

 

 

Toilet Riser – a toilet riser or potty chair with arms is a must after hip resurfacing surgery.  Most patients are required to follow the 90 degree rule and sitting or rising from a normal height toilet seat will break the rule.   Inexpensive toilet risers that look like big life savers are available at any drug store or discount store for about $20.  Fancier versions or the potty chair with arms are much more expensive.  The one problem with the plastic, inexpensive risers is they are not very big.  A large man sitting on a toilet riser does not have much room to do his business.  The inner diameter of the toilet risers is very small. They are fine for women, but often a problem for men.  Men should check out their options before surgery to make sure they can comfortable use the toilet adapter.

 

Reacher - Many people like to have one or two reachers in case they need to pick something up from the floor.  If you have a helper at home, you might not need one.  You can also bend down and pick something up from the floor by placing your operated leg behind you and bending the other leg.  I did that quite often when I had to feed dogs or pick anything up.  Of course, you need to be careful not to lose your balance. The reason you need to place your leg in back of you when bending is to prevent yourself from breaking the 90

 degree rule.

Grabber	Sock Putter On-er	Grab Bars	Tub Grab Bar

 

 

Sock Putter On-er – Some people find the sock putter on-er a great help.  If you have a helper, you can probably get away without one. If you don’t go sockless and don’t have a helper, you will find the sock helper useful because again you are not to break the 90 degree rule.  It is impossible to reach down to your feet to put socks on without breaking the 90 degree rule.

 

Grab Bar By Toilet – I had my husband install a grab bar on the wall next to my toilet.  I found it to be a great help in getting on and off the toilet. This is not required, but I am glad to have it installed.  I have back problems and it helps to have a nice grab bar by the toilet.

 

Grab Bar by Shower or Tub – I found myself to be very unsteady for a few weeks after surgery. Getting in and out of the shower without help was a problem. I was 61 and not a spry as a younger person, but felt I needed to be very careful not to fall. A Grab Bar by the shower or tub would be a great help for most people, even if they have not recently experienced surgery.

 

Raised Bed – If you have a low bed, you will want to consider a way to raise your bed.  Many of the newer beds and mattresses are fairly high and you can get in and out of bed without breaking the 90 degree rule. If your bed is low, raising your bed with special risers or just bricks or wood blocks, help getting in and out of the bed without breaking the 90 degree rule. Be careful that your risers are secure and your bed won’t slip off of them.  Test them out before your surgery.

 

Silky Sheets – These are certainly not required, but some ladies like to use them because they are slippery and it makes sliding on and off the bed much easier. Some ladies just wear silky PJs to allow them to rotate easily when getting in and out of bed. Men sometimes like to wear nylon warm up pants so they can rotate or slide in and out of bed easily.

 

Ice Packs	Foam Mattress Pad	TEDS

 

Ice Packs – Ice packs are often used by many hip surgery patients. Ice helps reduce swelling and also pain. There are many varieties of commercial ice packs available that you can freeze in your freezer.  Some people just use ice cubes in a plastic bag while others have used frozen bags of peas since they conform to your hip. The peas can be frozen over and over – Just don’t eat them after they have been thawed and frozen too many times!

 

Plastic Garbage Bags – Sitting on a plastic garbage bag when getting in and out of the car or bed makes it easier to rotate you body after surgery. It is often difficult to move your operated leg and body shortly after surgery.

 

Lazy Boy Type Recliner-Lounge Chair – Most people have a difficult time sleeping after hip surgery. Many people need to lie on their backs and it is often difficult to sleep in that position for days at a time. Many people find sleeping or napping in a nice recliner is a great help after surgery. I slept many nights in my Lazy Boy and took many naps in my favorite chair after surgery.  Many people like the La Fuma recliner chairs after surgery.  It is a personal choice as to which chair works best, but having some type of recliner is a definite help to most people.

 

Slip on Shoes – Many people find it much easier to use slip on shoes after surgery. You don’t have to worry about getting a helper to put them on and tie them for you.

 

Stool Softener– A stool softener or similar product is a must after surgery.  Many people start to take them just before surgery. The anesthesia and narcotic based pain meds often cause severe constipation.

 

Nice To Have Items

 

Pillows – Extra pillows to put under your legs while you are lying in bed. Extra pillows under your legs make lying on your back feel much better.  Also many doctors suggest you keep your legs elevated while laying down to help circulation and prevent blood clots. Dr. De Smet always suggests “toes above your nose when lying down.”

 

TEDS – An extra pair of TEDS comes in handy if you doctor suggests you wear them.  An extra pair allows you to wash one pair while you are wearing the other pair. You definitely need a helper to put TEDS on. Some people are able to use the sock putter oner to put them on, but I have heard it is quite a struggle.

 

Foam Mattress Pad – Foam mattress pads on top of your mattress help make lying on your operated side and even your back much more comfortable.  The closed cell foam tends to be too hot for many people, while others like the neoprene type egg carton foam.

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How To Select a Surgeon for Hip Resurfacing by Patricia Walter

 

Selection of a surgeon is a personal choice. It is a choice that makes you feel confident that your surgery will go well, that your surgeon has a good bedside manner and you can ask questions anytime you need answers.

 

When buying real estate the old saying about what is important is "Location, Location and Location." In many people's minds the most important factor in choosing a surgeon for hip resurfacing is "Experience, Experience and Experience." I realize that every hip resurfacing surgeon has to start somewhere to do his first operation, but I feel, in layman's terms, that hip resurfacing is as much of an art as it is a learned skill. The angle of the cap on the femur bone is very important, the proper amount of pounding to place the stem is important, shaping the femur bone for the cap is important, how the surgeon approaches the hip itself is important.  There are many, many factors involved in a successful hip resurfacing operation.

 

There have been studies done to determine the learning curve for Hip Resurfacing with the BHR and for Hip Resurfacing with the ASR. These studies and others indicate that a surgeon needs 50, 100 or more hip resurfacing operations to become experienced. I have personally been told by a very experienced doctor that a surgeon should do at least 100 hip resurfacings before a patient decides to use them. There is a LARGE AMOUNT of debate over this number and subject.  Many people feel that a surgeon is already experienced if he has been performing THR's for many years. Hip Resurfacing, however, is a much more demanding and technical surgery than a THR.

 

 

I personally feel that experience can only be learned, it can not be taught. Many professional sportsmen have learned the technical skills to play the game - but you generally see the most experienced quarterbacks, pitchers, or goalies playing in the pros.  The difference is the experience. These people learn almost instinctively what to do, they don't take time to reason and figure out what to do.  That is the kind of surgeon I want to do my hip resurfacing - a surgeon that has seen it all and done it all.  Unfortunately a surgeon that has only done 10 or 50 hip resurfacings has not seen it all and done it all.  My personal surgeon, Dr. De Smet, even told me that he still has very difficult surgeries and he has done over 2500 hip resurfacings.

 

I feel if a person has a more difficult hip problem such as advanced AVN, cysts, misaligned hips or an unusual physical problem they were born with - they need a very experienced surgeon. If you are an older female or even male, many surgeons will suggest a THR instead of a BHR.  The more experienced doctors are more willing to tackle more difficult problems since they have the experience.

 

I have personally read thousands of emails from hip resurfacing patients on the Yahoo Surface Hippy Discussion Group. My personal observation of post-op results show that the patients of the much more experienced surgeons usually have a quicker and easier recovery. There are always exceptions often due to the prior medical condition of a patients hip or muscles, but anyone can take time and read thru the thousands of emails on the discussion group and see how patients recover after their surgeries.

 

To sum up the question of "How to Select a Surgeon", choose a doctor that you feel comfortable with. Ask the doctor:

Some of the newer doctors are not as comfortable with hip resurfacing and will revert back to a THR if they encounter problems.  A THR is an easier operation than a Hip Resurfacing.  Make sure your doctor is a true advocate of hip resurfacing. Some of the new doctors have told me that they only use hip resurfacing in special situations and still prefer doing a THR in most cases. The very experienced hip resurfacing doctors will always give a person a hip resurfacing if possible - some have even changed their mind during a THR and ended up giving a patient a hip resurfacing.

 

Ask questions and opinions from other people, then trust your own instincts and make up your own mind. It is your hip and your life.

 

Patricia Walter Webmaster/Owner of Surface Hippy - A Patient to Patient Guide to Hip Resurfacing

 

Birmingham Hip gets rival in resurfacing

 

Smith & Nephew monopoly lost; FDA approves device from Britain

 

By Daniel Connolly July 18, 2007

 

The Birmingham Hip implant by British medical device maker Smith & Nephew was the first hip resurfacing product to go on sale in the United States and has helped drive revenue at the firm's Memphis-based orthopedic units.

 

But a recent federal decision means the company will now face a rival in the fast-growing hip resurfacing market.

 

Earlier this month, the Food and Drug Administration approved the Cormet 2000 hip resurfacing device from British firm Corin Group PLC. An FDA panel had recommended approval in February. Stryker Corp. of Kalamazoo, Mich., plans to distribute the devices in the United States later this year.

 

When the hip goes on the market, it will break the American monopoly that the Birmingham Hip has enjoyed since its FDA approval in May 2006. Currently, it's the only product available in the United States for hip resurfacing, a relatively new surgical procedure used as an alternative to traditional hip replacement.

 

Both techniques are used in patients who have osteoarthritis and other joint diseases that cause pain and limit mobility.

 

Proponents of hip resurfacing say it destroys less bone than standard hip replacement surgery and is better suited for younger patients who want to maintain an active lifestyle. However, some surgeons have expressed concerns about results, including about a higher-than average early failure rate.

 

Smith & Nephew representatives have said the product is safe and effective, and the Birmingham Hip has been a sales winner for the firm.

 

In the first quarter, for instance, sales of the Birmingham Hip helped increase revenue in the firm's orthopedic reconstruction unit 15 percent to $262 million.

 

A Stryker spokesman declined to comment on competition with Smith & Nephew.

 

Brian Austin, vice president and general manager of Smith & Nephew's hip division, expressed confidence.

 

"We are realizing tremendous growth, particularly in the U.S.," he said in a statement. "We have been aware of Stryker's possible entry into hip resurfacing and are ready. ... We have a world-class training program and have already trained close to 1,000 U.S. surgeons. We are continuing to exceed our growth goals and fully intend to keep our market leading position."

 

-- Daniel Connolly

 

Smith & Nephew

 

World headquarters : London.

 

Worldwide employees : More than 8,500.

 

Local headquarters : 1450 Brooks Road.

 

Local employees : About 1,800.

 

Local presidents : Mark Augusti, president, trauma and clinical therapies division; Joseph DeVivo, president for orthopedic reconstruction.

 

Web site : Smith-Nephew.com.

 

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Infection fear lessens for artificial joints

 

By Dr. Paul Donohue

 

07/08/2007

 

Dear Dr. Donohue: After 30 years of going to one dentist, my wife and I changed for convenience. We made an appointment for teeth cleaning. In the forms that had to be filled out, my wife listed her hip replacement and my knee replacement, both 15 to 20 years ago. The dentist refused to clean our teeth until we took antibiotics before the visit. We haven't done this in the past 20 years. Did you ever hear of this?

 

Have you ever heard of endocarditis? It's a heart and heart valve infection. People with a damaged heart valve or with an artificial heart valve take antibiotics before dental procedures that cause bleeding. In those procedures, mouth bacteria can get into the blood, and they home in on those valves. Antibiotics afford protection.

 

A similar situation holds for artificial joints. The fear is that mouth bacteria can home in on the new joint, causing an infection that's hard to treat and may require joint removal.

 

However, there is a revision of thinking. In the United States, about half a million artificial joints are implanted yearly. Multiply that number by the number of years this kind of surgery has been done and you come up with a huge figure. Since the first artificial joint was replaced, there have been only 25 cases of artificial joint infection after dental work. Many doctors feel that the potential danger of antibiotics is greater than the minuscule chance of joint infection.

 

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Medical Tourism Takes Flight

 

By Kathleen Doheny, HealthDay Reporter

 

FRIDAY, July 6 (HealthDay News) -- Soaring U.S. medical costs are causing many Americans to take to the skies on "medical tourism" junkets, looking for high-quality yet low-priced health care at foreign clinics.

 

In many cases, patients get exactly what they are looking for, but experts also warn that the booming industry does have some risks.

 

"My own advice would be to look carefully at the accreditation of the hospital and consider the nature of the procedure. Are you sure it is the procedure you need? And is it done well at the place you are going?" said Dr. Ann Marie Kimball, a professor of epidemiology and health services at the University of Washington School of Public Health, in Seattle.

 

The surge in medical tourism over the past decade is being driven by rising U.S. health-care costs and growing numbers of uninsured or under-insured Americans, said Josef Woodman, the author of a guidebook on the topic called Patients Beyond Borders.

 

Almost 45 million Americans, or slightly more than 15 percent of the population, are currently uninsured, according to U.S. Census Bureau statistics from 2005, the latest available.

 

 

Woodman estimated that more than 150,000 Americans traveled abroad for health care in 2006. The number is projected to double in 2007, he said.

 

...Even when patients select and book medical care abroad through a health travel agent, they must remain critical, informed health-care consumers, Woodman said.

 

The main thing a patient needs to do, he said, is check out the accreditation of the hospital and the credentials of the surgeon.

 

Spread of disease is another potential concern, said Kimball, who is also director of the APEC Asia Pacific Emerging Infectious Disease Network and author of Risky Trade: Infectious Disease in the Era of Global Trade.

 

"Medical tourism is obviously a route for pathogen spread," Kimball said, noting that different hospitals in different regions may have different types of flora. "The extent to which it's a problem versus a theoretical concern is as yet not known," she said. "I can't issue a blank 'go' or 'don't go,'" she added.

 

Kimball's advice: Look carefully at the accreditation of the hospital concerned and do your homework before you board the plane. "Check out the number of surgeries done, the success rates," Woodman added. It's also key to ask the surgeon you talk to if he or she will perform the operation, not an assistant.

 

Kimball said she urges potential medical tourists to talk it over with their own physician. As the concept and the practice of medical tourism has evolved, she said, a physician is not likely to automatically rule out the idea.

 

More information

 

There's more on medical tourism at the American Society of Plastic Surgeons...

 

SOURCES: Josef Woodman, author, Patients Beyond Borders, (Healthy Travel Media, 2007); Ann Marie Kimball, M.D., professor, epidemiology and health services, University of Washington School of Public Health and Community Medicine; director, APEC Asia Pacific Emerging Infections Network, Seattle, and author, Risky Trade (Ashgate Publishing, 2006); American Society of Plastic Surgeons, briefing paper

 

Copyright © 2007 ScoutNews, LLC. All rights reserved.

 

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F.D.A. Approves Corin's Cormet Implant

 

F.D.A. Approves a Hip Resurfacing ImplantBy BARNABY J. FEDER Published: July 4, 2007 The regulator approved Corin’s Corment implant, bringing competition to the increasingly common procedure.

 

Hip resurfacing, a popular alternative implant to total hip replacement for younger patients disabled by hip failure, is about to become competitive.

 

The Corin Group of Britain and Stryker said yesterday that the Food and Drug Administration had approved the Cormet hip resurfacing implant by Corin, thus giving American consumers an alternative to Smith & Nephew’s Birmingham hip resurfacing system for the first time since the F.D.A. approved that device in May 2006.

 

Stryker, based in Kalamazoo, Mich., has a 10-year distribution agreement with Corin covering sales of the device in the United States. Stryker said that it hoped to have enough orthopedic surgeons complete the training program agreed upon with regulators to begin marketing the Cormet by the end of September.

 

Although total hip replacement has become a common and exceedingly successful operation for patients whose natural hip has been irreparably damaged by illness or injury, resurfacing has attracted surgeons and many patients because it preserves more of a patient’s thigh bone. That makes it easier to replace the original implant with a total hip in the future if necessary, which is often the case for active patients who have their artificial hips for 15 or 20 years.

 

Some hip resurfacing advocates say the procedure also leads to quicker recoveries, greater range of motion in the hip and a more natural distribution of weight and pressure on the thigh bone, or femur.

 

Skeptics say that much is still unknown about the long-term safety and durability of the resurfacing devices compared with the total hips and that most patients, particularly those older than 65, should stick with the older technology.

 

Analysts have forecast that 10 percent to 15 percent of the nearly 300,000 Americans a year who get hip replacements might be good candidates for resurfacing. Both operations cost $25,000 or more at most hospitals that offer them.

 

The F.D.A. action came more or less when Wall Street had forecast, based on the support for the device by the F.D.A. panel that reviewed clinical trial results in February. About 8 percent of the 302 resurfacing patients in the trial needed revision surgery within two years, a figure that the panel and the companies agreed highlighted the importance of carefully training doctors to identify which patients were most likely to have good outcomes.

 

The approval was announced after trading ended on Wall Street yesterday. Shares of Stryker, which are up more than 16 percent this year, rose 49 cents, to $63.95. Shares of Corin rose 1.64 percent, to 559 pence, on the London Stock Exchange.

 

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