Ask the Doctors
You had written to me earlier asking for my current thoughts on the ASR failure and recall. The following is the mail that I sent to one of my patients which explains my current thoughts on the ASR . This ASR Recall and unexpectedly high failure rate has caused tremendous confusion for everyone concerned.
I started back in 1991 with the antero-lateral approach to the hip for resurfacing. At that time we were worried about blood supply to the femoral head and on theoretical grounds the antero-lateral approach preserved the blood supply well. For many patients the approach was satisfactory but there were some problems. The exposure obtained in large patients was not good.
Many times individuals develop certain conditions that cause their hips to hurt. Listed below are some common causes for discomfort in the hip joint region.
Traditional hip replacements are not durable enough for many of today's younger more active patients. Traditional metal-on-plastic bearing devices have been shown to fail at a rate of thirty (30%) percent by seven years in this patient group. Recently, several new bearing couples have been developed as more durable options
This is peculiar to resurfacing as the cup for resurfacing is a very large profile ie half a sphere. Nearly all THR cups are only portions ( arc) of a hemisphere.
It is a commonly used statement that a BHR is as stable as a normal hip. However this is a highly qualified statement.. This statement is true only if the following criteria are met.
Hello, I am new to this group. I am a 54 year old male with osteoarthiris in both hips, a former quarter miler at Bucknell University who can barely walk now. I have been very impressed by conversations I have had with Dr. James Pritchett in Seattle.
Not sure how they were implanting the cup since they were seeing impingement of the neck on the anterior cup. I real life the cup is inserted with enough anteversion and the anterior wall of the pelvis trimmed so that there is about 2 mm of anterior wall bone left proud of the cup. If there is correct anteversion of the cup then there should be no contact of the neck on the metal cup anteriorly with the minimal bony rim.
The first point I want to make is I have done hundreds or thousands of total hip replacements (THR) on all sorts of people at all sorts of ages and activity levels. Some of this experience pre-dates hip resurfacing, but I still often do THR as well. There were many very happy THR patients, but quite a few with a host of problems.
Recovery is gradual and somewhat variable from patient to patient. Most patients are pretty comfortable getting around without assistive devices (crutches or cane) within 2 to 3 weeks.
Although it is completely safe to get an MRI of a resurfaced hip, the images may be of poor quality unless special techniques are used. Since an MRI works by using a magnetic field to align water molecules and produces a picture based upon different water contents of the tissues
Yes, it is true that Minimally invasive approach has been proven not to have great benefits over a conventional incision in terms of blood loss, pain , or speed of recovery in the same surgeons hands. It is only of cosmetic value.