Doctor Information

Link  http://cbs4denver.com/local/Colorado.News.Denver.2.556499.html

By Kathy Walsh
 Feb 15, 2007

DENVER (CBS4) ― Doctors at Presbyterian Saint Luke's Hospital have started offering a new type of hip surgery aimed to help baby boomers who are having pain in their hips earlier than normal. The Birmingham Hip Resurfacing System was approved by the Food and Drug Administration last May.

The new surgery is an alternative to total hip replacement and aimed at people under the age of 60.

"It is something that patients have actually been waiting to have done," said Dr. Cindy Kelly at Presbyterian Saint Luke's.

One operation CBS4 witnessed took 2 hours as Kelly prepares the hip socket, then hammered a new metal one into place. Kelly shaved the damaged bone on the hip ball, preserving it rather than removing it. She then glued and pounded in a new metal cover.

"Patients have full motion, really without the risk of dislocation," said Kelly.

The new procedure allows for more activity. Patients could be up and moving in 6 weeks, but need to wait a year before running.

One benefit is that if a patient needs another hip replacement, the thigh bone is largely intact.

The new resurfacing procedure may not be for everyone. Patients should always consult their own doctor.

Link - Click here to see full article

Aug. 8, 2008

Since its introduction a decade ago, metal-on-metal hip resurfacing has become increasingly popular because it may conserve femoral bone, increase functional ability and be easier to revise than other procedures, according to an article published in the August issue of the Journal of Bone & Joint Surgery.

Michael A. Mont, M.D., of Sinai Hospital of Baltimore, and a colleague reviewed clinical results - primarily from studies conducted in England, Australia and Western Europe -- and highlighted 10 important lessons learned during the past 10 years.

The researchers found that metal-on-metal hip resurfacing now accounts for about 10 percent of total hip arthroplasties. Among the lessons they highlight is that patient selection is the key to success. They cite Australian data on more than 10,000 patients showing that metal-on-metal hip resurfacing is associated with similar or improved survivorship compared to standard total hip arthroplasty in men under age 65 but not in men over age 65, and that metal-on-metal hip resurfacing is associated with a higher risk of short-term failure in men over age 65 and in all women.

"In the Australian registry, hips that underwent resurfacing as treatment for osteoarthritis have had better survival than those that underwent resurfacing for the treatment of developmental dysplasia, inflammatory arthritis and osteonecrosis," the authors write. "In summary, resurfacing hip arthroplasty has had a tremendous increase in popularity because of the potential benefits of femoral bone conservation, possible increased functional ability, and ease of potential revision procedures. In young men, the survivorship has been similar to that of standard total hip arthroplasty."

Although none of the authors received outside funding or grants in support of their research, one or more of them reported that they or their family members received grants or payments from Wright Medical and DePuy during the past year.

 

A new surgical robot is making medical undergraduates three times more accurate during practice hip operations, according to pilot study to be discussed at a conference this week (8 February 2008).

Link News Website

 

Delegates at the British Society for Computer Aided Orthopaedic Surgery Conference will hear that results from a pilot study saw graduates 95 per cent more confident using this robotic technique than when using conventional surgical methods in training.

 

Professor Justin Cobb, Head of the Biosurgery and Surgical Technology Group at Imperial College London, conducted the trial on 32 undergraduate medical students at Imperial College London from December 2006 to December 2007. The pilot study tested whether planning before an operation, combined with the latest robotic navigation equipment could increase the success rates of students practising hip resurfacing arthroplasty procedures – a method for correcting painful hip bone deformities by coating the femoral head with a cast of chrome alloy.

Continue reading "Surgical Robot to Assist in Hip Resurfacing Surgeries "

Link  http://www.mariondaily.com:80/articles/2008/01/31/news/news01.txt

MARION - In the past, if you had hip problems in your 40s and 50s, you were looking at 20 years of pain killers and a limited lifestyle before you could get a hip replacement.

Orthopedic Surgeon Dr. Richard Morgan is offering a procedure for treating hip arthritis and other degenerative joint diseases that lowers the age of the target group by as much as 20 years.

Previously, the target group for hip replacement surgery was 70 years old. The replacements only lasted 20 years and the procedure was thus postponed until the patient was likely not to outlive the replacement.


That left a lot of younger patients in the position of having to live on painkillers.

Now Dr. Morgan is able to help younger patients with a different procedure called the Birmingham Hip Resurfacing System. It is the only FDA-approved hip resurfacing device in the United States.

“It is a more difficult procedure than a total hip replacement,” Dr. Morgan said. “The incision is larger, but less bone is removed.”

The reason the system lasts longer than traditional total hip replacements is that, with the Birmingham procedure, both the socket and the ball of the hip are made of metal and thus wear on the joint is minimal. These metal parts are attached to healthy bone and less real bone is removed for the procedure. Candidates for the Birmingham Hip must have healthy bone surrounding the joint.

The Birmingham Hip has been done for 20 years in England and the wear on the joints has proved to be minimal.

Dr. Morgan began doing the Birmingham procedure at Heartland about a year ago. So far he has done six of the new procedures.

Recovery is quick as with a total hip. Six weeks on a walker is all that is required.

Dr. Morgan cautions that the Birmingham procedure is designed to get people back on the golf course or back in the gym. It is not intended to restore a professional athlete to the NFL.

Link  http://www.iol.co.za/index.php?set_id=1&click_id=13&art_id=vn20060821014255934C837090

By Karen Breytenbach

Two American orthopaedic surgeons have been taught an innovative hip surgery technique by a local surgeon.

Leith Stewart, an orthopaedic surgeon at Claremont Hospital (South Arfrica), last week demonstrated the Birmingham Hip Resurfacing (BHR) procedure to his guests, Ian Kovack from Kansas and Donald Polakoff from New Jersey.

One patient was a professional golfer in her 30s and the other an active woman in her 60s. Both were told they would be up and on crutches within two days, instead of six weeks if normal surgery was done.

Both will also be able to drive, cycle and swim within three weeks instead of six.

Stewart, an avid cyclist and snowboarder, has been performing the procedure for six years. He had a BHR performed on his left hip about four years ago, with great success.

Since 1997 the procedure, developed by two British surgeons as a bone conserving alternative to total hip replacement, has been used on about 51 000 patients in the UK, Germany, Australia and South Africa.

The procedure was only recently approved by the US Food and Drug Administration, on condition that surgeons receive training.

While total hip replacement has yielded good results in elderly inactive people, the procedure has been less successful in young and active people, who respond better to resurfacing.

Hip resurfacing is the replacement of the cartilage covering the surfaces of the ball at the end of the thigh bone (femur) and the cup-shaped cavity (acetabulum) into which it fits, with cobalt chrome, into which bone grows" in weeks".

• This article was originally published on page 4 of The Cape Times on August 21, 2006

 

NEW JERSEY SURGEON INTRODUCES UNIQUE ALTERNATIVE TO TOTAL HIP REPLACEMENT
READ COMPLETE ARTICLE

Innovative Birmingham Hip Resurfacing™ System preserves bone and joint stability for young, active patients

Morristown, NJ. (November 30, 2006) - Dr. Wayne A. Colizza of Morristown Memorial Hospital is among an exclusive group of surgeons in this country who have been trained in the remarkable new Birmingham Hip Resurfacing (BHR) technique. Rather than replacing the entire hip joint, as in a total hip replacement, hip resurfacing simply shaves and caps a few centimeters of bone within the joint. Continue reading "Dr. Colizza of Morristown NJ Performs Birmingham Hip Resurfacing"

Apollo performs 1,000 hip surfacing surgeries
Friday October 12 2007

READ COMPLETE ARTICLE at New India Press

CHENNAI: Apollo Hospitals in the city has completed 1000 hip surfacing surgeries, a new technique which involves treating hip problems without hip replacement.

Hip surfacing is an innovative technique preserving bone in the hip in contrast to hip replacement, consultant orthopaedic surgeon at the hospital Dr Vijay Bose told reporters here.

"The surgery facilitates near normal hip function, enabling patients to be very active after surgery and free from any restrictions," he said.

It would be suitable for Asian patients as they could sit on the floor or go about their routine activities comfortably after the surgery, Bose said, adding it was also much longer lasting as it employed a metal on metal bearing.

He said the first hip surfacing surgery was done in May 2000. The youngest patient to undergo it was a 12-year old girl, three years ago.

The number of patients affected with hip problems was high among Asians, since they used more steroids for treating various diseases. "They use traditional medicines which contain a high amount of steroids, which cuts off blood supply to the hip and causes problems," he said...

READ COMPLETE ARTICLE at New India Press
 

All About Hip Resurfacing

Hip resurfacing is all the rage in the orthopedic community these days. In fact, I had four different hospitals pitch me stories on it in the last year, independent of one another.

But is it right for everyone with chronic, debilitating hip problems? NYMD News panelist Dr. William Macaulay, attending orthopedic surgeon at New York Presbyterian Hospital/Columbia and director of Columbia's Center for Hip and Knee Replacement, has the answers below and after the break.

By William Macaulay, M.D.

You just turned 40 or 50. Your mind tells you you’re younger, but you feel older because you have real hip pain that won’t quit. You limp everyday. You do a little research and come across a new procedure called total hip resurfacing. Then you wonder: Is this the right procedure for me?

I hear the same story over and over from my patients. Looking for a solution to their hip pain, they have stumbled upon total hip resurfacing, which was approved for use in the U.S. in May of 2006. While many patients are ideal candidates for resurfacing, often I must inform them that hip resurfacing is not for everyone.

Learning curve may be longer than thought for placing hip resurfacing components

 

It took surgeons 55 to 60 cases to get femoral components within ?5? of planned placement.

 

By Susan M. Rapp ORTHOPEDICS TODAY 2007; 27:12 May 2007

 

British and Australian researchers collaborating on a prospective study identified a longer-than-expected learning curve to accurately perform hip resurfacing arthroplasties.

 

Hip surgeons taking part in the study, all of whom had performed more than 1,000 hip surgeries, found they had to complete three-times more resurfacing surgeries than they expected in order to place the femoral hip resurfacing components within ?5? of the desired neck/head angle, said Diane L. Back, FRCS.

 

The surgeons had initially estimated their learning curve at 10 to 20 cases, Back told Orthopedics Today.

 

"The results actually showed that it took 55 to 60 cases for most of our surgeons to get the femoral component where they actually planned it," she said.

 

...Four surgeons participated Back and colleagues prospectively analyzed the first 100 hip resurfacing procedures of four consultant orthopedic surgeons, three from Australia and one from the United Kingdom.

 

They performed all procedures with the recently reintroduced Birmingham Hip Resurfacing System [Smith & Nephew]. The FDA approved the implant for sale in the United States last year.

 

All surgeons used standard instrumentation and a posterior approach. Investigators focused on femoral component position, but also analyzed notching and other complications.

 

To determine how accurately they placed the femoral components, surgeons first marked the ideal implantation site on preoperative radiographs. Investigators then calculated the corresponding neck/head angle.

 

...The longer-than-expected learning curve has huge implications for surgeons' success with this type of hip replacement, Back told Orthopedics Today.

 

"Hip resurfacing is good. I think that is well proven. You have to choose your right cases, but it does take you longer than you expect to learn. I think medico-legally it does have some implications."

 

For example, 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, she said.

 

In the United States where orthopedists 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.

 

Back said she wonders how, with the worldwide trend toward reduced orthopedic training hours, many new surgeons would be able to accrue enough cases to become proficient with the technique.

 

READ COMPLETE ARTICLE

This is a list of questions compiled by Pat Dukes, Vicky Marlow and members of the Yahoo Surface Hippy Discussion Group.  Print it out and take it to the doctor with you.

 

 

You should ask your doctor as many of the questions that seem appropriate for your situation.  Your doctor should be patient, willing to talk about what to expect and answer your questions.  If he or she isn't, I would try to find a doctor that is open and helpful. There are many wonderful hip resurfacing surgeons that will answer any question you have. Having all your questions answered will give you peace of mind and will make your surgery much less stressful.

 

How many resurfacings have YOU done? (not observed or assisted with)
Where did you train?
How many complications have you had?
How many resurfacing failures with revision to THR have you had?
How many times during surgery have you had to change to a THR instead
of a resurfacing and why was the change made?
What device (prosthesis) do you use, how long have you been using it
and why do you prefer it?
Do you use cemented or uncemented? Why?
Do you cement the stem?

What anesthetic do you use?
How long does the surgery take?
What surgical approach do you use? Anterior or Posterior?
What is the incision length?
What is your post-op pain control plan?
What hospital do you use?
What is their infection rate?
Have any of your patients had infections that required IV antibiotics
following resurfacing?
What drugs/methods do you use for anti-coagulation after surgery?
How long will I be in hospital?
How successful have you been obtaining insurance approvals for
resurfacing?

What is the rehab protocol?
When will I be 100% weight bearing?
What assistive devices will I use for walking after surgery?
How long on 2 crutches, 1 crutch, cane?
What if any restrictions do you place on your patients after surgery
and how long do they last?
Will I be given any at home nurse or PT care?

How does my other hip look at this time?
If both hips are bad, how do you handle bilateral resurfacing?
Is there anything unusual about my hip that might present problems?
Do you have a resurfacing patient who you've done surgery on that I
could talk to about their experience?

What is your opinion of my returning to (whatever work or activities
you do)
Have you done resurfacing for anyone who has returned to these
activities?"