Articles 2008

Link  http://www.timesonline.co.uk/tol/life_and_style/health/article3641322.ece

Baby boomers are competing for hip operations with older people, and the pain and strain will be felt by the health service

Martin Richards has been sports-mad all his life, playing five-a-side football, tennis, squash and badminton. At 50 he tried taking up waterskiing but found that he couldn't crouch down to pick up the tow handle; if he fell he had difficulty getting up again. “I would lie there like a beached whale,” he says.

He thought he probably had a groin injury, but pain and difficulty moving got worse, he put on weight and eventually X-rays showed advanced osteoarthritis. “Your hips are shot,” a consultant told him. “I went away, lost 2st (12.7kg), then came back for the operation. A year later I had the other hip done.”

Richards was soon back playing all his favourite sports, fishing and camping. At 57, five years after surgery, he says that he feels fantastic: “It was a total life change. I feel very lucky.”

Richards underwent a procedure called hip resurfacing, invented ten years ago in Birmingham by the orthopaedic surgeon Derek McMinn and named the Birmingham Hip, though there are now many imitations. Instead of removing the head of the thigh bone and replacing it with an artificial ball (hip replacement) a hollow metal cap is fitted over the head of the thigh bone, which corresponds with a metal casing inside the hip socket. The procedure is now recommended by the National Institute for Health and Clinical Excellence (NICE) for younger and more active patients though not all orthopaedic surgeons agree about its role. “Some see it as a holding operation,” says Jane Tadman, of the Arthritis Research Campaign, “postponing the day when a traditional hip replacement will be needed. Others claim it is a perfectly good - and less invasive - procedure in its own right.”

Because resurfacing is a relatively new technique, there is little data on outcomes, though early reports suggest a success rate of more than 95 per cent at five years after surgery. In one trial, hip resurfacing performed better in young active patients than total hip replacement. But the materials used were different - metal on metal for the resurfacings, metal on polyethylene for the replacements - and it may be that if the more expensive metal or ceramic bearings were used, the replacement would perform better.

“Hip resurfacing has been well marketed,” says Tom Pollard, an orthopaedic specialist registrar. “But it is not yet certain that it is superior to total hip replacement using comparable materials in the longer term.”

Martin Richards was told that his new hips should last about ten years, though he admits he probably does too much. “They may wear out before then.” He says that it's important to be a good weight before and after surgery, and you have to work hard to regain fitness: “I couldn't have done it without the support of physiotherapists at my local hospital. If I can get to 60 with these hips, swimming, playing tennis and squash, I'll have had a good run.”

Richards may need total hip replacement if his resurfacing fails, but one advantage of resurfacing is that this is usually a straightforward procedure compared with revision of a primary total-hip replacement.

Helen Cotterell was only 42 when she began to feel pain in her knee that increased in intensity over the next six years and osteoarthritis was diagnosed in her right hip. “My GP told me: ‘Oh you're miles off a replacement'.” A friend recommended her to see a consultant privately who gave her a year before she would need surgery. “When I went back, I'd worn another quarter of an inch off the bone.” Resurfacing was recommended because she was so young: “He said it could stand one or possibly even two revisions before I would need a full replacement; he reckoned he could get me through into my nineties.” Even so, Cotterell was uncertain: “Do I really need this op?” she asked. “You tell me,” said her consultant. “I thought, yes, I want to climb mountains with my kids, who were only 10 and 13 at the time, I want to keep up Scottish reeling, I don't want to limp down Oxford Street and sit in agony like an old woman in Topshop while my daughter tries on clothes.”

After a second operation on her other hip, Cotterell went to a remedial masseuse: “She taught me how to walk properly - swinging each foot forward like a catwalk model rather than waddling, which I'd got used to when the hips hurt.” She has no idea why the disease struck her so young: “My grandfather had a hip replacement at 70 but he was crippled by then. They were more stoic, that generation, weren't they?”

Smith & Nephew and Corin battle to win over America's hip generation

Link http://business.timesonline.co.uk/tol/business/industry_sectors/health/article3601581.ece

Smith & Nephew and Corin are both vying to win the key US market for hip replacements

Matthew Goodman

BEFORE he had surgery, Cory Foulk, a 49-year-old Hawaiian architect, found even everyday tasks such as getting in and out of the car caused him considerable pain. His condition, arthritis triggered by a cycling accident, had deteriorated over several years.

Three years ago, though, he had a hip replacement. US doctors had been reluctant to carry out the procedure on such a relatively young patient, but Foulk went abroad and found a British surgeon prepared to do the work using a new type of implant that had yet to make its way to America. The new hip was made by Smith & Nephew, the FTSE 100 medical-equipment group.

Link  http://03530.com/2008/03/25/horse-stopped-from-visiting-patient-at-hospital-bedside.html

Wilcox Hospital has around 70 beds, includes an intensive care section and offers treatments for cardiac and a range of other conditions. It is part of Hawaiian Pacific Health.

Two Kaua’i patients who had not seen each other for 25 years were recently reunited at the hospital. Payton Hough and Jeff Habig were the first to receive the new Birmingham hip resurfacing procedure at the hospital, performed by orthopedic surgeon David Rovinsky.

Corin Group Introduces Vertical machining centre to reduce lead times

Medical implants and instrumentation manufacturer has introduced 'lean' cell-structured machining systems - including high speed machining - to reduce overall manufacturing lead times

Link  http://www.manufacturingtalk.com/news/siz/siz235.html

Medical implants and instrumentation manufacturer, the Corin Group, has introduced lean, cellular production techniques, which have transformed individual component machining times, as well as overall lead times. Newly-established routines have also streamlined production through reduced work handling and separate set-ups.

In addition, investment in another area has eliminated costly outsourced machining operations and allowed the company to take full control over its processes.

By establishing cell machining incorporating a Fanuc Alpha T21E high speed, 24,000 rev/min vertical machining centre (VMC), has, for example, been able to demolish lead times on hip replacement 'cups' from three days down to just one day.

Also, Corin invesed in two Fanuc Alpha wire EDM machines, to bring back in-house previously sub-contracted wire edm work.

Production manager, Trevor Buggins, at Corin explained that the Group's global reputation had been built around a policy of continual improvement.

It impacts every department of the 200 plus-employee company, which in more recent times, has attracted increased business from countries such as Japan, North America, Turkey and Venezuela.

Corin produces a wide range of products for the medical sector, hip, knee, ligament and spinal replacement items, as well as 'instrumentation packs' that provide surgeons with a complete set of tools for the appropriate task.

The company processes stainless steel, titanium and cobalt chrome alloys, for example, in various quantities to meet its growing forward order book and stock demands.

A 'flagship' product, the Cormet Hip Resurfacing system, combines the principles of conservative arthroplasty with metal-on-metal bearing technology to provide a solution for patients with osteoarthritis or rheumatoid arthritis.

It is in producing the components for Cormet that the Fanuc Alpha T21E VMC has been used to impressive effect.

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Here's a nice story, if it happens: Lightning coach John Tortorella has given captain Tim Taylor the option of playing in the team's final game of the season April 5 at Atlanta. It would be a way for the center to finish his 13-year career as a player instead of on the sideline, where he has been since Sept. 7 hip surgery.

"He deserves that type of respect,'' Tortorella said. "He's been a loyal guy to the organization and has done a lot of things on and off the ice people don't even know about, so he deserves that right.''

The surgery is called hip resurfacing and corrected his painful, right-hip dysplasia by shaving and smoothing the head of the femur, topping it with a chrome alloy cap and fitting it into the hip socket that also was coated.

Taylor, 39, said he is "ecstatic'' at the results. He has skated since mid February but has practiced fewer than 10 times.

Read Tim's Hip Resurfacing Story by clicking here

"I don't want to say yes. I don't want to say no,'' Taylor said of playing. "Now I'm practicing every day. Maybe the last day of the season, maybe I get that itch.''

If Taylor doesn't play, he will end his career with 746 games, 73 goals, 167 points and Stanley Cups with the Lightning in 2004 and Red Wings in 1997.

Seemed the more we talked about it Monday at the Ice Sports Forum, the more Taylor liked the idea of playing.

"That would be nice,'' he said. "To sit on the bench at the end of a game and to know, 'Okay, it's over now,' would be really nice.''

Dave Grigg Ten Year Anniversary

L C+ 3/24/1998 R C+ 2/12/2004 Dr. Amstutz

I'm saying hello on the eve of my ten year anniversary. In early 1998 there were fewer than 40 resurfacings in the U.S. and of course no surfacehippy group or knowledge base. My thanks to Keith and all you posters.

My story

A former runner, I had been crippled with OA for a decade and needed crutches just to stand more than 2 minutes. Dr. Amstutz said he'd only seen one or two more diseased hips in his career. I placed a lot of trust in him and it sure paid off. I was riding the life cycle 5 days post-op and skydiving 7 weeks post-op (not doctor approved). My other hip was resurfaced by the good doctor early in 2004. I moved to the Palm Springs area 19 months ago and took up competitive tennis, both singles and doubles and have won a couple of local tournaments.

Other than airport security delays, I couldn't be happier.

Dave C+, Dr. Amstutz, L 3/24/1998, R 2/12/2004

Farmer has hip op in India

Link  To Original  Story

LAURA DEVLIN

18 March 2008

Stuart Agnew - operation in India

Farmer Stuart Agnew knew that major surgery was on the cards as his hip became increasingly more painful during a busy lambing season.

But for the 58-year-old, being at the mercy of NHS waiting lists was a daunting thought as he tried to negotiate his way through a hectic farming calendar.

Eventually, the pain became so intense that he felt forced to take action and sought out private treatment halfway across the world in India.

Yet there was an unexpected bonus awaiting him when he discovered he could not only have the surgery at a time to fit in with the day-to-day business of running the farm, but save himself £5,000 in the process.

Mr Agnew, who represents the county on the NFU's national council, became so frustrated at struggling around his farm at Helhoughton, near Fakenham, that he searched the internet for an overseas surgeon and braved a nine-hour flight to Bombay.

Bloodless hip surgery at GSMCH

Link  http://www.punjabnewsline.com/content/view/9315/38/

Tuesday, 18 March 2008

CHANDIGARH: Bloodless hip surgery would be performed at the Gian Sagar Medical College and Hospital, near here, with an internationally acclaimed orthopaedic surgeon Gursharan Singh Chana visiting the hospital regularly every two months.

Disclosing this here Tuesday, Dr Sukhwinder Singh, vice-chairman of the Gian Sagar Educational and Charitable Trust, said that Dr Chana, who is settled in the United Kingdom, would visit the GSMCH every two months.

He would train orthopaedic surgeons in bloodless hip surgery for which a 15-day training course would be organized every two months.

Dr Sukhwinder Singh said that Gursharan Singh Chana, a doctor of Indian origin, would deliver a lecture on minimal invasive surgery for total hip replacement and hip resurfacing at the Gian Sagar Medical College and Hospital on March 20.

He said that Dr Chana would interact with the faculty of the GSMCH on March 20 morning and in the evening he would address orthopaedic surgeons of Patiala. On March 21, he would be interacting with orthopaedic surgeons of Chandigarh and on march 22 he would have an interactive session with orthopaedicians of Ludhiana.

Dr Sukhwinder Singh said that an internationally acclaimed orthopaedic surgeon, Dr Chana has devised a minimally invasive approach to hip joint to carry out total hip replacement and hip resurfacing. He has devised Chana reamer handle to allow accurate surgery of the hip joint.

Dr Chana is presently working as a consultant orthopaedic surgeon at the Royal Orthopaedic Hospital, NHS Trust Birmingham, since October 2002.

Dr Chana has the vast experience of carrying out the over 2500 total hip replacements, over 2000 total knee replacement, over 1500 hip resurfacing, 200 hip replacements using minimally invasive surgical approach, 200 hip resurfacings using minimally invasive hip resurfacing.

Over the last two years he has been involved in developing instrumentation and implants for hip resurfacing procedure to be carried out using a minimally invasive approach through Comis Orthopaedics, a company based in Yorkshire.

The implant is being used currently in the U.K. This implant is the only one of its kind that can be delivered using a minimally invasive approach with obvious benefits of early discharge from hospital, blood transfusion is not necessary in 95 per cent of patients and the patients tend to return to normal activities at an earlier stage compared to patients who undergo open surgery. The average incision size is 7 cm. with this approach as opposed to 20 cm. using an open approach.

Link Link http://www.kplctv.com/Global/story.asp?S=8029116&nav=menu66_5_1

March 17, 2008

Reported by: Britney Glaser

Each year, 200,000 Americans undergo total hip replacement.  For younger patients leading active lives, this surgery can oftentimes leave them with physical limitations they did not have before going under the knife.  But now, there's an exciting new hip procedure - one that's transformed the cycling career of a Tour de France winner.

For 15 years, cycling has been Floyd Landis's passion - but when he broke his hip while training in 2003, the arthritis that developed eventually became unbearable.  "It's hard to explain arthritis if you've never had it," says Landis, "it's just something that's always there - and it affects everything, it affects your mood.  I'm quite happy that it's been solved."

Landis peddled with the pain until 2006.  After winning Tour de France, he chose a revolutionary technique called Birmingham Hip Resurfacing to repair his hip.  Orthopaedic surgeon, Dr. John Noble, performs the BHR procedure locally and says it's the ideal alternative to total hip replacement in younger patients.  "I would say that the young, active patients who have significant arthritis or significant dysplasia - that is a shallowness of the socket - those are patients who would benefit from hip resurfacing," says Dr. Noble.

BHR uses a bone-conserving technique where surgeons shave just a few centimeters of bone rather than removing the entire hip joint.  "We divide the tissue directly over the bone," says Dr. Noble, "we make an exposure to dislocate the hip and move the hip and ball out of the way to allow exposure to the socket and then we ream the socket with a device that looks like a cheese grater and then we implant the socket."  The size of the implant is matched to the patient's own joint, reducing the risk for dislocation or uneven leg length.

Dr. Noble says the results have been phenomenal.  "99.5 percent of the patients were either pleased or very pleased with their procedure," says Dr. Noble, "and those are pretty extraordinary results - we just don't see that very often with many operations."

It's been a year and a half since Landis had the BHR procedure.  He is now back to riding and says his determination *and hips are the strongest they've been in years.  "It's as good as new," says Landis, "and certainly is much better than it was the last two years when I had the arthritis problem.  I'll certainly be better off and not just because of that, but more determined than ever."

*If you're wondering what brought Floyd Landis to Southwest Louisiana, he took part in a ride over the weekend that raised $5,000 for the Calcasieu Community Clinic.

*To learn more about the BHR technique, click here.