Hip Resurfacing News - BHR

Hip-Hip-Hooray! Exciting New Hip and Knee Resurfacing Surgery Comes to

nospam@example.com (Patricia Walter) — Mon, 18 Aug 2008 19:01:34 -0700

8/18/08

Like most people, you probably want to keep your body parts for as long as possible. Innovative hip and knee surgery at San Joaquin Community Hospital (SJCH) can help you do just that. It's called resurfacing, and it's life-changing.

Bakersfield, CA (eMediaWorld) August 18, 2008 -- Like most people, you probably want to keep your body parts for as long as possible. After all, God gave them to you for a reason. Innovative hip and knee surgery at San Joaquin Community Hospital (SJCH) can help you do just that. It's called resurfacing, and it's life-changing.

According to the Centers for Disease Control and Prevention, there were 383,500 hip replacements and 550,800 knee replacements in the United States in 2005, and the numbers are rising. You don't have to be one of them.

Birmingham Hip Resurfacing

Gary Shepard, a 56-year-old from Bakersfield, has been athletic most of his life. It took its toll. He's been in pain for countless years, limping and walking at a 45 degree slant. He couldn't even cross his legs, so in 2007 he had Birmingham Hip Resurfacing (BHR™).

"The change is dramatic. It feels like my own hips. I walk straight, I've grown two inches, and even my knees don't swell anymore. People can't believe it when they see me---I feel fantastic," says Shepard.

Your hip is a ball-and-socket joint that unites two separate bones---femur (thighbone) and pelvis. The femoral head is a ball that fits into the pelvis socket. In the standard total hip replacement (THR), ball and socket are completely removed and replaced. The femoral shaft (thighbone's long part) is hollowed out and a spike, which holds the ball, is pressed into the bone. The spike can loosen and cause bone wear.

It's completely different with resurfacing. The femoral shaft is never disturbed---there is no spike. A minimal amount of the ball is shaved and then fitted snuggly with a smooth metal cap. The socket is shaped to fit a polished metal cup that the bone naturally takes on as its own.

Resurfacing preserves bone, improves range of motion, and gives you freedom to have a highly active, normal life. And that's a great thing.

Resurfacing was available years ago; it didn't last long. Technology and metal implants were far less sophisticated than today. Patients can now expect superior results with new medically-advanced implants.

In 2007, BHR™ celebrated its 10th anniversary. It has been used in 26 countries with a worldwide success rate of 97.2 percent. The FDA approved its use in the United States in 2006.

"With BHR™, I remove a lot less bone than in hip replacement. Oftentimes it's only 10 percent of the femoral head," says Tom Ferro, MD, FAAOS, orthopedic surgeon. "Patients experience less pain and report that it feels like their own hip. Resurfacing patients appear to feel normal very quickly, frequently by the second day after surgery.

"Another huge advantage to preserving bone is that you have more to work with later if your hips are injured."

It's just a fact of life: once bone is removed, you can't put it back.

Ferro, the leader in BHR™, is one of approximately 50 surgeons nationwide who perform this procedure. It requires considerable expertise in resurfacing. Although his clinic, the Bone & Joint Center, is located in Arroyo Grande and San Luis Obispo, Ferro also performs BHR™ in Bakersfield but only at SJCH.

"The hospital is extremely receptive to state-of-the-art procedures, and they have the patient's best interests at heart. It's important that patients have the finest technology used by the best people and in a highly efficient system---that's San Joaquin," says Ferro.

This procedure is recommended for active people under 66 years of age with good bone quality. There are some exceptions. Always talk to a physician to identify your best options.

"After seeing the huge change in me, friends and relatives are considering this for themselves. My wife spent a lot of time researching BHR™. I highly recommend it, and you can't do much better than Dr. Ferro," says Shepard.

Hip Resurfacing in India: WorldMed Assist Makes Surgery Abroad Possible for Californian

nospam@example.com (Patricia Walter) — Mon, 18 Aug 2008 18:52:41 -0700

By Wouter Hoeberechts
8/18/2008

Experts in medical tourism, WorldMed Assist's mission is to improve lives by helping patients receive high quality medical treatment abroad at affordable prices.

Pioneertown, CA, Aug 18, 2008 - Steve Berg returned from a 15-day trip for hip resurfacing in India, a trip that only four months earlier he'd never imagined. He also never thought he'd be joining the fast growing ranks of medical tourists traveling overseas from North America for surgery they can't afford at home.

Last October, Steve Berg went to his chiropractor for an alignment to alleviate hip pain that caused him to pop up to 16 ibuprofens a day. But x-rays soon confirmed the chiropractor's initial suspicion: severe arthritis, not a chiropractic adjustment, would require surgery. The diagnosis was confirmed by an orthopedic surgeon. He was then hit with further bad news: hip replacement anywhere near home would cost about $60,000 because he was among the 47 million uninsured Americans forced to gamble that they'll never need serious medical attention.

He didn't have $60,000.

He hit the internet, and learned about an alternative to hip replacement - called hip resurfacing - that would provide him higher range of motion, shorter recovery time and the chance for future hip surgery should the arthritis cause further joint deterioration.
Berg, whose career restoring vintage motorcycles requires lots of mobility, chose Birmingham Hip Resurfacing (http://www.worldmedassist.com/Hip_Resurfacing_Surgery_India.html), but soon learned it's impossible to find an experienced doctor in the U.S. because it's a procedure only recently (2006) approved by the FDA. Berg found that several countries overseas had been resurfacing hips for a lot longer than in the U.S.

"There's a steep learning curve with this procedure, and I didn't want anyone in the U.S. practicing on me. When you look at our hospitals, you see a very high percentage of doctors from India, so I decided to go to the source!" Berg chuckled.

"First, I tried to arrange surgery in India myself, but I got so tangled up with all the options and paperwork, that I almost gave up," Berg recalled. "Finally, I landed on http://www.WorldMedAssist.com and was impressed with their information about hip resurfacing. I e-mailed them, and they immediately called me back to talk about details. I told them, "You're hired! Line up my options for India, and let's push this through as fast as we can."

With options in hand, Berg chose Wockhardt in Mumbai because their surgeon, Dr. Malhan, had done a large number of hip surgeries and is UK board certified. WorldMed Assist forwarded all Berg's records to Dr. Malhan, who then assured Berg he was a good candidate for hip resurfacing.

"WorldMed Assist quoted me a total cost of just over $10,000, including hip surgery, hotel, a two-week hospital stay and all my travel - about 1/6th the price I faced in the U.S. That price even included dental work I'd been putting off for 7 years. My decision was clear, and three weeks from the time I first contacted WorldMed Assist, I was on a plane."

While recovering from surgery in a private hospital suite complete with a refrigerator, visitor's couch, computer, cable TV and his own deluxe bathroom, Berg met several other medical travelers. About a third had made their own arrangements, as Berg had attempted to do; several others had used global healthcare facilitators like WorldMed Assist.

"But no one had as clean an experience as I did," he said. "The biggest deal is having handlers at home who line up people to lead you through the entire overseas process. I told these other patients about WorldMed Assist's service - how they expedited my visa, ensured I was met at the airport and driven directly to my hotel, and above all, how they stayed in touch with me from our very first contact throughout the entire ordeal. Those patients were all pretty amazed at the level of service compared with their own experience. WorldMed Assist handled all those loose ends I turned out to be incapable of pulling together on my own."

"Now, I'm home, and already back to work. The pain in my hip was gone a week after surgery. Before surgery, I could only stand for one hour and then I needed to lie down on a hot pad for two hours…that makes for pretty slow progress restoring these motorcycles."

About WorldMed Assist
Experts in medical tourism, WorldMed Assist's mission is to improve lives by helping patients receive high quality medical treatment abroad at affordable prices. WorldMed Assist coordinates and simplifies every aspect of care and travel. WorldMed Assist also provides medical tourism as an option for self-insured businesses seeking expanded and affordable healthcare options for employees. Hip Resurfacing in India and Belgium is significantly less expensive than in the U.S., yet delivered with the same or higher quality care and results as set by U.S. standards. Waiting times are virtually eliminated, track records are proven, and facilities are state-of-the-art. For more information, go to http:/www.worldmedassist.com
Press Release Distribution By PressReleasePoint(http://www.pressreleasepoint.com)

Contact:

Wouter Hoeberechts
WorldMed Assist
Pioneertown, CA
866-999-3848 X710
whoeber@worldmedassist.com
http://www.worldmedassist.com

Dr. Bose Transcript of Chat on Aug. 16, 2008

nospam@example.com (Patricia Walter) — Mon, 18 Aug 2008 15:10:48 -0700

Click here to view a Transcript of the Surface Hippy Chat with Dr. Bose on Aug. 16, 2008

New Hip Surgery Designed For Younger Patients - Dr. Kelly

nospam@example.com (Patricia Walter) — Mon, 18 Aug 2008 12:42:36 -0700

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.

Smith & Nephew revenues hit £500m for first time

nospam@example.com (Patricia Walter) — Mon, 11 Aug 2008 18:00:19 -0700

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.

Metal-on-Metal Hip Resurfacing Growing More Popular

nospam@example.com (Patricia Walter) — Fri, 08 Aug 2008 17:00:21 -0700

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.

Smith & Nephew posts first $1B quarter

nospam@example.com (Patricia Walter) — Thu, 07 Aug 2008 16:54:12 -0700

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.

FDA wants surveillance net for orthopedic devices

nospam@example.com (Patricia Walter) — Mon, 04 Aug 2008 21:01:09 -0700

Link http://www.govhealthit.com/online/news/350502-1.html

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.

Hip joints resurfaced instead of Replaced

nospam@example.com (Patricia Walter) — Tue, 15 Jul 2008 20:47:17 -0700

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.

Hip Resurfacing Shows Narrower Edge Than Anticipated

nospam@example.com (Patricia Walter) — Tue, 17 Jun 2008 11:19:50 -0700

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.