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to learn about hip resurfacing.
I have a large Patient to Patient website dedicated to Hip Resurfacing called
Surface Hippy. About 8000 unique visitors a month use the website to learn about hip resurfacing.
Many don't have time to keep up with what's new in hip resurfacing, so I decided
to place news media articles about Hip Resurfacing on the Hip Resurfacing News
Website. It is a place to quickly find out what is new and what is
changing in the field of hip resurfacing.
Hip Resurfacing came of age in the United States when the
FDA approved Birmingham Hip Resurfacing (BHR) in May 2006. Previous to the FDA Approval, hip resurfacings were done in Europe, Canada, Australia and other countries outside the United States. Orthopedic surgeons have been performing hip resurfacing surgeries since 1997 in most countries. Over
90,000 people world wide have received hip resurfacings.
Since the FDA Approval of the BHR and Cormet in the US, there are a large
number of new surgeons learning the techniques and many people wondering if the
surgery is right for them. There are new surgeons training, new medical studies
completed regularly and general articles published in newspapers, magazines and
in the media daily. Keeping up with all of the information becomes a real task
for most people. People are trying to find pertinent information without
spending hours and hours searching online - that is the purpose of Hip
Resurfacing News.
Patricia Walter - Owner/Webmaster of Hip Resurfacing News and
Surface Hippy
Tuesday, July 15. 2008
http://www.signonsandiego.com/uniontrib/20080715/news_1c15alivem.html
July 15, 2008 SAN
DIEGO ALIVE
With more people in their 40s and early 50s being
sidelined by severe osteoarthritis, a new technology – hip resurfacing as an
alternative to hip replacement – is giving baby boomers a chance to stay active
longer.
 |
Robyn Benincasa, a runner and San Diego
firefighter, had a new hip resurfacing procedure.
|
The Birmingham Hip Resurfacing system takes only the
cartilage off the outer part of the ball and socket joint, and installs a
cobalt-chromium steel cap and cup that slides more smoothly than hip
replacements, lasts longer and has less potential for leg-length
discrepancy. Widely used in the U.K. since 1997, the BHR system was approved
for use in the U.S. in May 2006.
This week, San Diego Alive, the Union-Tribune's
video health feature, spotlights local adventure racer and San Diego
firefighter Robyn Benincasa, who, under the care of La Jolla orthopedic
surgeon Dr. Michael Kimball, had the procedure. Five months after Kimball
resurfaced Benincasa's troublesome hip, she ran across Vietnam.
Tuesday, June 17. 2008
AAOS SAN FRANCISCO, March 7, 2008 - Some of the purported advantages of hip
resurfacing over standard arthroplasty, though not all, seem to be real,
researchers found in a randomized trial.
But other pluses in activity and function can probably be chalked up to patient
selection bias and expectations, reported Martin Lavigne, M.D., of the
University of Montreal, and colleagues, at the American Academy of Orthopaedic
Surgeons meeting here.
In the randomized trial, patients who had hip resurfacing were significantly
more likely to return to work and sports and had better step and hop test scores
than standard arthroplasty patients did.
But functional scores and range of motion were no better than with hip
replacement, the investigators found.
Hip resurfacing gained popularity with patients and some orthopedic surgeons on
the basis of assumptions about better clinical function and ability to return to
a high level of activity.
While retrospective cohort studies reinforced this perceived benefit, Dr.
Lavigne said, "obviously there was a bias in the patient selection for hip
resurfacing." Patients who sought hip resurfacing tended to be younger, more
active, healthier, and expected a more active life after surgery, he said.
The newer procedure is still controversial among orthopedic surgeons despite
rapid increases, commented Tom Schmalzried, M.D., of the Orthopaedic Hospital in
Los Angeles, in a press conference where there was debate over the two
approaches.
"The results of good, modern total hip replacement are really, really good," he
said. "So for resurfacing to have a favorable risk-to-benefit ratio, you have to
show you are getting something you don't get with total hip replacement."
For a more objective answer to this issue, Dr. Lavigne's group randomized 210
patients who were candidates for either procedure to undergo either uncemented
28-mm metal-on-metal total hip arthroplasty or hybrid metal-on-metal hip
resurfacing.
All procedures were done by the same three surgeons with a posterior approach.
Patients were informed which surgery they underwent only afterward.
Patients had a mean age around 50. Body mass index was higher in the total hip
arthroplasty group.
Functional scores were slightly worse in the hip replacement group at six months
(17 versus 11 on the WOMAC scale) but identical by two years (5 for both).
At six months after surgery, hopping on the affected leg was significantly
easier for resurfacing group patients ("easy" or "very easy" 91.7% versus 78.9%
and "difficult" or "impossible" 8.3% versus 21.1%, P=0.023).
Likewise, climbing stairs in a step test was easier at six months in the
resurfacing group compared with the replacement group ("easy" or "very easy"
94.4% versus 76.3% and "difficult" or "impossible" 5.6% versus 23.7%, P=0.015).
Hip resurfacing group patients were also more likely to return to their prior
work (96% versus 83%, P=0.02).
The young age of the patients made this an important outcome, Dr. Lavigne said.
Among the patients, 152 had data on activity level pre- and post-procedure.
Despite similar activity levels before surgery (P=0.22), more hip resurfacing
than hip replacement patients returned to sports activities by one year after
surgery (15% versus 7% high impact and 38% versus 28% moderate impact activity,
P=0.022).
On a scale that included activities of daily living as well as sports, the
difference tended to favor hip resurfacing but was not significant at one year
(P=0.074).
"Both groups returned to a high level of activity," Dr. Lavigne said. "Hip
resurfacing patients seem to be more active, but not as much as expected."
Type of surgery had no significant impact on what factors patients reported as
limiting their return to sports activities, including implant protection,
discomfort, fear of instability, and thigh pain.
Hip range of motion -- including total arc, arc of rotation, flexion-extension
arc, and abduction-adduction arc -- was also similar for both groups among the
122 patients with data on this outcome (P>0.05).
Satisfaction with the procedure was uniformly high over time and across
treatments.
While resurfacing is a more aggressive technique, Dr. Lavigne said, the rate of
complications was similar between groups.
Long-term follow-up will be important to determine whether there are differences
in need for revision between the procedures, he concluded.
Dr. Lavigne reported receiving research or institutional support from Zimmer,
Stryker Howmedica, Biomet, DePuy, and Smith & Nephew and consulting for Zimmer.
Dr. Schmalzried reported receiving research or institutional support from
Stryker, DePuy, Johnson & Johnson, Corin, and Wright Medical Technology;
receiving miscellaneous funding from Stryker, DePuy, Johnson & Johnson, Corin,
Wright Medical Technology, Zimmer, and Smith & Nephew; receiving royalties from
Stryker, DePuy, Johnson & Johnson, Corin, and Wright Medical Technology; holding
stock options in Stryker, DePuy, Johnson & Johnson, Corin, Wright Medical
Technology, Zimmer, Biomet, Bristol-Myers Squib, and Pfizer; and being a
consultant for Stryker.
Primary source: American Academy of Orthopaedic Surgeons meeting
Source reference:
Lavigne M, et al "Range of motion after hip resurfacing and THA: A single-blind
randomized clinical study" AAOS meeting 2008; Abstract 058.
Additional source: American Academy of Orthopaedic Surgeons meeting
Source reference:
Lavigne M, et al "A randomized study comparing surface replacement arthroplasty
to total hip arthroplasty" AAOS meeting 2008; Abstract 056.
Additional source: American Academy of Orthopaedic Surgeons meeting
Source reference:
Lavigne M, et al "Return to sports after hip resurfacing and total hip
arthroplasty: A randomized clinical trial" AAOS meeting 2008; Abstract 053.
Tuesday, June 17. 2008
Link
http://www.argusleader.com/apps/pbcs.dll/article?AID=/20080616/LIFE/806160306/1004/life
Ken Kuipers' hip pain started in 2006. At first, the 51-year-old Platte
farmer tried to tough it out.
Even though a couple doctors recommended hip replacement, Kuipers wasn't ready
to give in.
"I wanted to keep my own joint as long as possible," he says.
Doctors told him he could try cortisone injections, but Kuipers ruled that out
because the shots were expensive and provided temporary relief. He needed to
keep up with his animals and field work, so when the pain didn't ease up, Dr.
Matthew McKenzie, orthopedic surgeon at the Orthopedic Institute, offered
another option.
Kuipers was a perfect candidate for hip resurfacing, McKenzie says. People who
are active, younger than 65 and have normal bone tissues have the best chance
for success with the procedure, he says.
Doctors also consider the expected life span of the patient before deciding on
the type of surgery performed. Hip replacements don't last forever.
"There is about a 20 percent failure rate in 25 years, depending on what study
you're looking at," McKenzie says.
He has done the resurfacing procedure for about nine months, something that
Orthopedic Institute added because patients were going out of town to have the
surgery, he says.
A hip resurfacing procedure has the same goal as a standard total hip: Pain
alleviation. Contrary to popular belief and Internet promises, the procedure is
not less invasive or expensive nor does it mean a shorter recovery time.
With hip resurfacing, Kuipers faces six weeks of healing, the same time a total
hip replacement would have taken. The newer surgery is not cheaper because new
technology always costs more, McKenzie says.
The main reason to have a hip resurfacing is because it means less bone removal.
"If it fails, you can revise it to a standard total hip," he says. "Anything to
save bone is the right thing to do."
During a hip resurfacing procedure, the ball of the hip is machined down, a
metal cap is fitted over it and a short anchoring spike is driven down the
femur. The neck of the femur is preserved as well as much of the ball. The
position of the implant and the patient's muscles hold the hip in place.
In a traditional hip replacement, the entire ball and joint is removed and
replaced with an artificial joint, and a long rod is placed in the femur.
Kuipers' incision is 10 inches long, that compared with a hip replacement that
is typically half that or less.
He was in the hospital for several days. He had the surgery on a Wednesday and
went home Saturday. He had two physical therapy sessions on Thursday and Friday
while in the hospital, says his wife, Donna. They taught him stretching and
strengthening exercises to do at home.
He's using a walker right now.
"I'm just about ready to switch to a cane," he says.
The pain is better but different, he says. It's surgical pain from the muscles
being cut. And he still needs pain pills to sleep.
At two weeks post-op, he had his first office visit where his staples were
removed and his incision was looked over. Healing is progressing, and McKenzie
gave permission to increase activity as tolerated.
"I was given the go ahead to get on a tractor," Kuipers says.That's exactly what
he plans to do as soon as it dries out enough to get in the fields.
Monday, June 2. 2008
Dr. De SmetVicky Marlow,
Patient Advocate/Technical Contributor, asks "What is your
opinion on cementless devices for resurfacing?"
Maybe they are good, but we do not know yet. Cement is a shock
absorber between prosthesis and bone or between prosthesis/
bone+cement/ bone, so maybe a good thing, certainly taking in
account that Chrome Cobalt has not the same elasticity as bone
and is quite stiff!
So
Greetz
KOEN
Read More Doctors Opinions About Cementless Hip Resurfacing Here
Friday, May 23. 2008
Friday, May 23. 2008
Dr.
Bob Arnot's Bilateral BHRs with Dr. Su
Read Dr. Bob's Complete Story by Clicking Here
As a television medical
correspondent for decades on shows like Today,
Dateline and the CBS evening News and author of 12
books on consumer medicine, I have to admit it. I
have never faced a more vexing decision than
choosing between a total hip replacement and hip
resurfacing. The claims and data appeared wildly
contradictory and each surgeon’s take was miles
apart from the others...
...I called great friends in
orthopedics at the leading Harvard hospitals and in
NY, Baltimore and Los Angeles. The word I got was
emphatic. Don’t do the hip resurfacing, it’s a
failed concept. It failed in the 70s and its doomed
to fail again...
...I began reading the entire world
literature. I called doctors in France, England,
Belgium, Germany. The more I read, the less I seemed
to know...
...Then I came upon
Surface Hippy Website and read everything on it...
...I went back over my notes, reread
the literature and it suddenly became incredibly
clear. What did I really want?
...The decision ended up being a no
brainer. Hip resurfacing with two BHRs .
READ MORE
Friday, May 23. 2008
Monday, May 12. 2008
Hip resurfacing helped triathlete compete again
Link
www.dallasnews.com
The patient before: Michael Montgomery, 33 years old, of Trophy Club was a
31-year-old Ironman triathlete.
For more than three years, triathlons offered him some semblance of normalcy.
Most of his life revolved around a stressful job in which he traveled the
country as a business-applications consultant.
That is, until he began having intolerable hip pain after the 2006 Ironman
Arizona. In four months, he went from finishing a marathon to being unable to
run a 5K.
An old hip injury from his college wrestling days probably caused avascular
necrosis, a condition following the loss of blood supply that resulted in his
hip tissue dying and the bone collapsing.
Initially, Mr. Montgomery thought total hip replacement was his only choice and
that he would never run again. Through research, he learned that cyclist Floyd
Landis of Tour de France fame had a similar diagnosis and had undergone a newly
approved option using the Birmingham Hip Resurfacing System.
Dr. Jay Mabrey, chief of orthopedics at Baylor University Medical Center at
Dallas, had just become certified to use the device. He had chaired the Food and
Drug Administration Orthopaedic and Rehabilitation Devices Panel, which approved
the implant in May 2006.
It's riskier than total replacement and appropriate only for young, active
patients.
The patient now: Six months after the procedure, he completed the April 2007
Ironman Arizona.
What is it? The Birmingham Hip Resurfacing System preserves more bone than total
hip replacement. It's similar to a tooth cap. Doctors shave and cap a few
centimeters of the bone within the joint with a metal implant rather than
replacing the entire joint.
Why he chose it: Mr. Montgomery wanted to resume running. A total hip
replacement device can't withstand the impact of running.
What you need to know: The Birmingham Hip Resurfacing System has a higher
failure rate than total hip replacement. Total hip replacement makes sense for
most people who are content to do low-impact activities.
Collapsing bone threatened to sideline triathlete Michael
Montgomery (left),
but a hip resurfacing procedure returned him to competition.
He and
Dr. Jay Mabrey examine his X-rays.
Thursday, April 10. 2008
Link
http://nwanews.com/nwat/News/64008/
BENTONVILLE — John Hill
has run several Boston Marathons over the years, but crossing the finish
line in 2006 was anything but pleasant.
Hill, a Bentonville resident for more than a decade and an executive
with Nestle in Rogers, was accustomed to tackling the 26. 22-mile
marathon in Beantown in as little as three hours, 27 minutes. But on
April 17, 2006, Hill’s time skyrocketed to just shy of six hours. And he
was in excruciating pain on top of that. “ The only way I even made it to the finish line was to stop every so
often and put more ice in my shorts, ” Hill recalls. “ I knew the end
was near. It was going to be over for me. I wasn’t going to be able to
run anymore. ”
Once a confident long-distance runner, Hill had been diagnosed with
osteoarthritis prior to legging out the 2006 Boston Marathon. And at 44
years old, the condition had nothing to do with age. Instead, an extra
piece of bone on Hill’s hip was rubbing against cartilage in the right
joint of his hip, causing the protective material to deteriorate at a
much more rapid rate than usual. The only surgical procedure being
prescribed was total hip replacement — and that would mean giving up
running altogether.
While attempting to stomach the fact that part of his life would soon
be erased, Hill stumbled upon a story about a new surgical procedure
called hip resurfacing. The procedure was so new, in fact, that it was
not yet approved by the Food and Drug Administration, few had been
performed in the United States, and the majority of insurance companies
were not covering the procedure. Still, a glimmer of hope was ignited
that has led to Hill holding on to the life he has always known.
On April 21, Hill, now 46, will be among the more than 20, 000
runners from across the country competing in the Boston Marathon. More
importantly, Hill, who underwent the hip-resurfacing procedure 14 short
months ago, expects to run the world’s oldest and most popular marathon
pain-free, and even has his eye on finishing in under four hours.
“ If I think about it too much, I get overcome with emotion, ” Hill
said. “ A year ago, none of this would have been possible. It wasn’t
even imaginable. When you get a second chance at life like I have, you
can’t help but feel humbled. I had already been told to start developing
my exit plan from running. And in a few weeks, I’ll be doing the Boston
Marathon. ”
The hip-resurfacing procedure, performed on Hill by Dr. Robert
Barrack in St. Louis on Jan. 23, 2007, has been practiced in Europe for
several years but has just recently started to gain acceptance in the
United States. Rather than removing the entire hip, the resurfacing
procedure introduces a special metal into the hip joint where the
cartilage once was. As a result, bone-on-bone contact, which causes
arthritis, pain and disability, is replaced by metal on metal.
The realization that he would not have to lose his hip meant Hill
could continue to run marathons. But, more importantly, he would remain
the father and husband he had been to that point in his life.
“ I coach my 6-year-old daughter (Mary Lou’s ) softball team, and
there was a time when I was having trouble getting from one end of the
field to the other, let alone running, ” Hill explained. “ I have a
9-year-old daughter (Sophie ) and an 11-year-old son (Brody ) that run
AAU. I’ve always been right there, running with them. I enjoy being
involved. My family is a priority. When my doctor performed the surgery,
that was the thing I told him. I said, ‘ Now I can play with my kids. ’
”
Read Complete Story
http://nwanews.com/nwat/News/64008/
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