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Tuesday, January 5. 2010
The Influence of Head Size and Sex on the Outcome of Birmingham Hip Resurfacing
READ ORIGINAL STUDY BY CLICKING HERE
The Journal of Bone and Joint Surgery (American). 2010
Callum W. McBryde, MD, FRCS(Tr&Orth)1, Kanthan Theivendran, MRCS1, Andrew M.C.
Thomas, FRCS1, Ronan B.C. Treacy, FRCS(Tr&Orth)1 and Paul B. Pynsent, PhD1
1 Research and Teaching Centre, Royal Orthopaedic Hospital, Bristol Road
South, Northfield, Birmingham B31 2AP, United Kingdom. E-mail address for C.W.
McBryde: cwmcbryde@hotmail.com
Investigation performed at the Royal Orthopaedic Hospital, Birmingham, United
Kingdom
Background Hip resurfacing has gained popularity for the
treatment of youngand active patients who have arthritis. Recent
literature has demonstrated an increased rate of revision among
female patients as compared with male patients who have undergone hip
resurfacing. The aim of the present study was to identify any
differences in survival or functional outcome between male and female
patients with osteoarthritis who were managed with metal-on-metal hip resurfacing.
Methods A prospective collection of data on all patients
undergoing Birmingham Hip Resurfacing at a single institution was
commenced in July 1997. On the basis of the inclusion and exclusion
criteria,1826 patients (2123 hips, including 799 hips in female
patients and 1324 hips in male patients) with a diagnosis of
osteoarthritis who had undergone the procedure between July 1997 and
December2008 were identified. The variables of age, sex,
preoperative Oxford Hip Score, component size used, surgical
approach, lead surgeon, and surgeon experience were analyzed. A
multivariate Cox proportional hazard survival model was used to
identify which variables were most influential for determining
revision.
Results The mean duration of follow-up was 3.46 years
(range, 0.03 to10.9 years). The five-year cumulative survival rate
for the655 hips that were followed for a minimum of five years was
97.5% (95% confidence interval, 96.3% to 98.3%). There were
forty-eight revisions. Revision was significantly associated with
female sex (hazard rate, 2.03 [95% confidence interval,1.15 to
3.58]; p = 0.014) and decreasing femoral component size hazard rate
per 4-mm decrease in size, 4.68 [95% confidence interval, 4.36 to
5.05]; p < 0.001). Revision was not associated with age (p = 0.88),
surgeon (p = 0.41), surgeon experience (p = 0.30), or surgical
approach (p = 0.21). A multivariate analysis including the covariates
of sex, age, surgeon, surgeon experience, surgical approach, and
femoral component size demonstrated that sex was no longer
significantly associated with revision when femoral component size
was included in the model (p = 0.37).Femoral component size alone
was the best predictor of revision when all covariates were analyzed
(hazard rate per 4-mm decrease in size, 4.87 [95% confidence
interval, 4.37 to 5.42]; p <0.001).
Conclusions The present study demonstrates that although
female patients initially may appear to have a greater risk of
revision, this increased risk is related to differences in the
femoral component size and thus is only indirectly related to sex.
Patient selection for hip resurfacing is best made on the basis of
femoral head size rather than sex.
Sunday, August 16. 2009
US Hip Resurfacing Implants Market: Product Penetration to Drive Growth
2009-08-14
The US hip resurfacing implants market valued at
$57.3.million in 2008 is forecast to grow by 36% annually for the next seven
years to reach $483 million by 2015
This growth is expected to be driven by an increase in awareness of the
procedure, increasing clinical familiarity among surgeons and a favorable
reimbursement scenario.
The fact that hip resurfacing offers a more natural feel, higher stability and
lesser bone-loss makes it ideal for patients leading an active life.
Increasing awareness of the advantages that this procedure offers, through
campaigns by both the manufacturers and social groups will drive the growth of
the US hip resurfacing market. There has been a steady increase in the awareness
of hip resurfacing, and it’s offering of an active life even after surgery, its
shorter recovery period, lower costs of rehabilitation and its minimal bone loss
factors. These advantages have positioned hip resurfacing as a primary treatment
method for hip ailments.
The increasing incidence of osteoarthritis in the population group of 25-60
years is a major driver for the US hip resurfacing market. The increasing
prevalence, now at 6% of the young patient population, is expected to drive
growth in the US hip resurfacing market. Osteoarthritis, which first appears
between the age of 25 and 40, is a very common disease in individuals aged 70
and above. Before the age 55, it affects men and women equally but after the age
55, the incidence is higher in women. Effectively, the large pool of male
population between the ages of 25-40 with advanced or severe arthritis of the
hip are expected to drive demand for hip resurfacing impalnts.
Smith & Nephew leads the US hip resurfacing market with its Birmingham Hip
Resurfacing (BHR). Released in May 2006, the BHR had the competitive advantage
of being the only available product for a full year until the market launch of
Corin’s Cormet System in July 2007. Smith & Nephew cashed in on the first mover
advantage with innovative marketing, surgeons education and competitive pricing.
Renewed efforts towards capturing distribution channels and increased stress on
surgeons education has allowed Smith & Nephew to capture 75% market share in the
US hip resurfacing market.
Corin’s deal with Stryker for distribution of its Cormet resurfacing system
played a major role in the sales of its device in spite of the late entry into
the US market. Stryker is known to have one of the strongest sales forces in the
US orthopedic devices market. This combined with Stryker’s strong brand identity
as compared to the UK headquartered Smith & Nephew has allowed Corin’s product
to effectively make inroads into the hip resurfacing market in the US.
For more information on this report click here:
www.global-market-research-data.com/Report.aspx?ID=US-Hip-Resurf ..
GlobalData, the industry analysis specialists’ new report, “US Hip Resurfacing
Implants Market: Product Penetration to Drive Growth”, finds that an increasing
incidence of osteoarthritis in the population group of 25-60 years will drive
the growth of hip resurfacing implants market in the US. The report highlights
the trend of traditional Total Hip Replacement (THR) shifting towards Hip
Resurfacing as one of the key market drivers for the US hip resurfacing market.
Thursday, July 30. 2009
Smith & Nephew 2Q Net Profit +15%; Deferrals Greater In Young
July 2009
LONDON (Dow Jones) Medical technology company Smith & Nephew PLC (SN.LN)
Thursday July 30, 2009 reported a 15% rise in second-quarter profit, but
said key products like its Birmingham hip resurfacing system are being
disproportionately hit by the recession, as younger people are more likely to
put off surgery than retirees.
Smith & Nephew said sales growth for replacement hips and knees is slow, as
patients continue to put off going under the knife while worries about the
economy persist. Growth in global sales of its knee products was 1% on the year,
while the hip sales declined 1%.
The company said products like its Birmingham hip resurfacing system, or BHR,
and its Journey knee implant have "a greater exposure" to the effects of the
recession because the rate of deferrals for operations is highest among young,
privately-insured patients.
Peers like Stryker Corp. (SYK), Johnson & Johnson (JNJ) and Zimmer Holdings Inc.
(ZMH) have reported a similar softness in the multi-billion dollar a-year market
for new joints.
Smith & Nephew said net profit for the three months to June 28 rose to $118
million from $103 million a year earlier, on revenue down 7% at $926 million.
That's just ahead of analysts' average forecast of about $117 million net
profit.
Monday, August 11. 2008
Link
Click here to read complete story
August 7, 2008
Europe's largest medical devices firm, Smith & Nephew, which manufactures hip
implants in Birmingham, has posted better-than-expected second-quarter earnings
as revenues hit £500 million for the first time, boosting its stock.
The group confirmed its outlook for the full year, including the impact of
problems at its Plus Orthopaedics, where the company revealed it had uncovered
"unacceptable" sales practices three months ago.
Chief executive David Illingworth said: "We have generated quarterly revenues of
$1 billion (£512 million) for the first time, as a result of a very solid
performance across all of our businesses."
"In Reconstruction we have seen good growth in both our hip and knee product
lines; in Trauma the actions we have taken in sales management have begun to pay
off; Endoscopy has delivered double-digit revenue growth and in Advanced Wound
Management we have outperformed the market. We are confirming our guidance for
the full year and we believe that the long term outlook for our business is
excellent," he added.
In Orthopaedic Reconstruction, global hip revenue growth was a solid seven per
cent due to good contributions across all products and regions.
The Birmingham Hip Resurfacing System now has an estimated 3.5 per cent share by
volume of the total US hip market after only two years in the market.
Investors welcomed the performance.
Nomura Code analyst Charles Weston said: "All the divisions did well on their
sales and they've confirmed that the sales hit from Plus will be $100 million
(£51 million), which is effectively positive because there are no new
negatives."
Pre-tax profit rose to £80 million from £75.3 million a year earlier. Sales were
£512 million, an underlying increase of eight per cent, or 23 per cent on a
reported basis.
Thursday, August 7. 2008
August 7, 2008
Link
http://www.bizjournals.com/memphis/stories/2008/08/04/daily35.html
Smith & Nephew PLC reported revenue of $1 billion for the fiscal second
quarter ending June 28, a 23 percent increase compared to $813 million for the
year-ago quarter. This is the company's first ever $1 billion quarter.
Based in London, Smith & Nephew (NYSE: SNN) is a global medical technology
business with 8,800 employees worldwide. The company's orthopedic
reconstruction, orthopedic trauma and clinical therapies divisions are based in
Memphis.
For the second quarter, the company reported net income of $198 million, an
increase of 18.6 percent compared to $167 million in the second quarter last
year.
Revenues for the Memphis-based reconstruction unit grew by 8 percent to $396
million. Global hip revenues grew 7 percent in the quarter. While the 2-year-old
Birmingham Hip Resurfacing System now has a 3.5 percent share of the total U.S.
hip market, management said sales growth slowed a bit in the quarter on
competitive pressures. U.S. knee revenues grew 12 percent in the quarter.
The trauma and clinical therapies division grew 5 percent in the quarter to $171
million.
Management said revenues in both units were strongly impacted by the purchase of
the former Plus Orthopedics Holding AG. The purchase plunged second quarter
revenues down an estimated $19 million and profits down by $9 million. The
company said bringing Plus on board will cost $100 million in the next year.
Monday, August 4. 2008
By Peter Buxbaum
Published on August 4, 2008
The Food and Drug Administration has proposed a
program that would query public and private databases to help study the efficacy
of orthopedic implants.
FDA will issue a request for quotations next month in an effort to identify
companies that could evaluate orthopedic implant registries for participation in
the program.
The program is part of the broader Sentinel Initiative FDA launched earlier this
year. The broader effort is intended to monitor and provide early warnings of
potential problems with FDA-approved medical products.
The implant program would “create a national network of registries for the FDA
in support of the Sentinel Initiative,” according to an FDA announcement posted
July 25. Implants of interest would include total hip, total knee, hip
resurfacing, intervertebral disc implants and ankle devices.
The program would create a distributed network to enable FDA to query multiple
data sources for information about medical products. As envisioned, queries to
the network would be accomplished with minimal data transfer and would protect
patient privacy.
FDA’s current post-market surveillance programs require “health care
professionals and patients to first recognize an association between an adverse
effect and a medical product, and then report it to FDA,” an FDA spokesperson
said. “Most adverse events are never reported, and when they are, the
information provided is incomplete.”
FDA officials envision being able to search government databases, such as the
Medicare database, private and public medical claims databases, and electronic
health record systems, the spokesperson said.
The proposed evaluations of the orthopedic implant registries will lead to
recommendations for involvement of the most promising data sources, the FDA
announcement states.
The Sentinel Initiative “could also ultimately facilitate data mining and other
research-related activities,” the spokesperson added.
Monday, February 25. 2008
Patients hip to new surgical technique
Link
http://www.suburbanchicagonews.com/beaconnews/business/807983,2_3_AU24_CASTLE_S1.article
February 24, 2008
By ROWENA VERGARA rvergara@scn1.com
AURORA -- It's a breakthrough that has rocked Europe for the last 10 years.
Internet bloggers can't stop buzzing about it. And every year, Americans are
going overseas just to get it -- until now.
It's not some cosmetic procedure or the latest fad diet program. But the
Birmingham Hip Resurfacing System, approved by the U.S. Food and Drug
Administration in 2006, has gained the attention of baby boomers and active
seniors who have the aches and pains (likely from arthritis), but don't want to
commit to a total hip replacement.
One of the select facilities across the United States doing the procedure is
Castle Orthopaedics & Sports Medicine in Aurora. Dr. Mark Shinsky of Castle
Orthopaedics, who joined the practice in September, is one of the only surgeons
in the Fox Valley trained to implant the Birmingham hip.
Made of cobalt chrome, the implant includes a metal cap anchored by a pin that
locks into the femoral neck. A metal socket then hooks into the pelvis bone.
Only a few centimeters of bone around the ball are shaved to fit tightly inside
the hip implant.
In comparison, a total hip replacement requires the loss of the femoral head, or
ball, which is replaced by a metal ball. That is then attached to a metal stem
that goes into the shaft of the femur. The socket is replaced with metal and
plastic components.
The Birmingham hip is recommended for people younger than 65 who are active and
want to return to a mobile lifestyle, Shinsky says. A hip replacement, in
comparison, is usually meant for patients in their late 60s and early 70s who
live a sedentary lifestyle.
Although it gained FDA approval two years ago, the procedure has been done more
than 60,000 times around the world since 1997.
"Patients like it a lot, and they do extremely well after this surgery and
bounce back well," Shinsky said.
Jack Giesenschlag, 49, of Oswego, had the procedure done by Shinsky at
Rush-Copley Medical Center in October. Five weeks after the surgery, he went
back to work, and traveled for business appointments within seven weeks.
He plans to get back into bowling, something he hasn't been able to do for six
years because of a deformed left hip. Giesenschlag acquired Leg Perthese
disease, a children's syndrome in which circulation to the femoral head is
blocked.
"It was hurting me on an everyday basis. I used to be a collegiate bowler, and I
gave up golf last year because I couldn't tolerate the pain of it," he said. "I
would have to say it was almost pain free going through the entire process."
The Birmingham's cobalt chrome components make it more durable than a total hip
implant. Traditionally, only the ball in a hip replacement is made from cobalt
chrome and the socket is lined with a plastic cup, which could wear out over
time, according to the Birmingham Hip Resurfacing Web site.
The dislocation rate is also virtually nonexistent. Dislocation is the leading
cause of implant failure in a total hip replacement, according to the site.
Still, total hip replacements are performed 300,000 times a year in the U.S.
Recovery time after the two-hour procedure is also impressive. Shinsky says
patients can go back to skiing, swimming, playing tennis or running hopefully
within a year.
The Birmingham hip is not the only device available to patients wanting a
resurfacing procedure, so it is recommended that patients research their
alternatives, and speak with a physician.
Monday, January 28. 2008
New Promising Data on S&N’s BIRMINGHAM HIP™ System
Link
http://www.ryortho.com/NEWSSHORTS/volume3/issue39/12-10-07-NS-New.htm
By Elizabeth Hofheinz, MEd, MPH December 10, 2007
No more wondering Down Under. The data is in. Smith & Nephew, Inc.’s
Orthopaedic Reconstruction business is announcing the release of positive
six-year clinical data by the Australian Orthopaedic Association National Joint
Replacement Registry on the company’s BIRMINGHAM HIP Resurfacing System (BHR™).
According to the company, the BHR, which has now been implanted in nearly 80,000
patients in 26 countries, conserves more of a patient’s bone than a traditional
hip replacement, enabling younger, more active patients to undergo hip
replacement surgery while preserving all future surgery options, including a
primary hip replacement. The design of the BIRMINGHAM HIP Resurfacing System
also offers patients a reduced risk of dislocation. The report revealed that the
BHR device has the highest hip resurfacing system survivability rate among all
of its established competitors for which data had been collected.
Included in the Australian report was the following information:
Since the inception of the registry, the BIRMINGHAM HIP Resurfacing System has
been the overwhelming choice of patients—over 75% of resurfacing procedures have
used the BHR device.
According to the registry, hip resurfacing accounts for 7.9% of all primary
hip replacements.
Commenting in the news release was Joseph DeVivo, President of Smith &
Nephew Orthopaedic Reconstruction: “We are extremely pleased with the
Registry’s results. The report once again highlights the ability of the
BIRMINGHAM HIP Resurfacing System to help people maintain the most active
and healthy lifestyle possible. The BIRMINGHAM HIP Resurfacing System lets
active people live the life they love and continue to pursue their passions.
The long-term clinical data available clearly demonstrates the benefits of
the BIRMINGHAM HIP Resurfacing System, which is the gold standard for
resurfacing technology in the world and a significant addition to our
reconstructive product portfolio in the United States.”
The Registry evaluates the timing and reasons for revision surgery as well
as mortality rates, and it measures the success rates of products and
procedures across Australia. This year’s report is based on the analysis of
332,700 hip and knee procedures undertaken in 271,188 patients from
September 1999 through December 31, 2006.
According to the company, the study is highly regarded for its
comprehensiveness and accuracy because the Registry is able to obtain a
near-complete set of data relating to hip and knee joint replacement for an
entire country. The Registry receives information from all public and
private hospitals undertaking joint replacement. Using a strict validation
process and following retrieval of unreported records and checking of
unmatched data, the initial validation for the 2005/6 Registry data resulted
in over 96% of Registry records verified against health department data.
Saturday, January 12. 2008
New Promising Data on S&N’s
BIRMINGHAM HIP™ System
Link
http://www.ryortho.com/NEWSSHORTS/volume3/issue39/12-10-07-NS-New.htm
By Elizabeth Hofheinz, MEd, MPH December
10, 2007
No more wondering Down Under. The data
is in. Smith & Nephew, Inc.’s Orthopaedic Reconstruction
business is announcing the release of positive six-year
clinical data by the Australian Orthopaedic Association
National Joint Replacement Registry on the company’s
BIRMINGHAM HIP Resurfacing System (BHR™). According to
the company, the BHR, which has now been implanted in
nearly 80,000 patients in 26 countries, conserves more
of a patient’s bone than a traditional hip replacement,
enabling younger, more active patients to undergo hip
replacement surgery while preserving all future surgery
options, including a primary hip replacement. The design
of the BIRMINGHAM HIP Resurfacing System also offers
patients a reduced risk of dislocation. The report
revealed that the BHR device has the highest hip
resurfacing system survivability rate among all of its
established competitors for which data had been
collected.
Included in the Australian report was the following
information:
Since the inception of the registry, the BIRMINGHAM HIP
Resurfacing System has been the overwhelming choice of
patients—over 75% of resurfacing procedures have used
the BHR device.
The BHR System has a revision rate of 0.8 per 100
component years or 2.5%.
The BHR System’s rate is derived from 19,585 component
years, 19 times that of any other resurfacing
competitor.
Three alternative hip resurfacing systems were cited for
their high revision rates.
According to the registry, hip resurfacing accounts for
7.9% of all primary hip replacements.
Commenting in the news release was Joseph DeVivo,
President of Smith & Nephew Orthopaedic Reconstruction:
“We are extremely pleased with the Registry’s results.
The report once again highlights the ability of the
BIRMINGHAM HIP Resurfacing System to help people
maintain the most active and healthy lifestyle possible.
The BIRMINGHAM HIP Resurfacing System lets active people
live the life they love and continue to pursue their
passions. The long-term clinical data available clearly
demonstrates the benefits of the BIRMINGHAM HIP
Resurfacing System, which is the gold standard for
resurfacing technology in the world and a significant
addition to our reconstructive product portfolio in the
United States.”
The Registry evaluates the timing and reasons for
revision surgery as well as mortality rates, and it
measures the success rates of products and procedures
across Australia. This year’s report is based on the
analysis of 332,700 hip and knee procedures undertaken
in 271,188 patients from September 1999 through December
31, 2006.
According to the company, the study is highly regarded
for its comprehensiveness and accuracy because the
Registry is able to obtain a near-complete set of data
relating to hip and knee joint replacement for an entire
country. The Registry receives information from all
public and private hospitals undertaking joint
replacement. Using a strict validation process and
following retrieval of unreported records and checking
of unmatched data, the initial validation for the 2005/6
Registry data resulted in over 96% of Registry records
verified against health department data.
Tuesday, January 8. 2008
Link
http://www.orthosupersite.com/view.asp?rID=25098
Newer implants with proper patient selection may make this a better procedure.
By Keith R. Berend, MD
ORTHOPEDICS TODAY 2007; 27:82
December 2007
In terms of hip resurfacing versus total hip arthroplasty, the questions we have
to address are: Is metal-on-metal the right choice for the patient; Is the
resurfacing more conservative; What are the indications for resurfacing; and Is
the large head metal-on-metal total hip better in most patients than a
resurfacing?
Keith R. Berend
Continue reading "Hip Resurfacing - Time for a second look"
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