James W Pritchett - Hip resurfacing with a highly cross-linked polyethylene acetabular liner and a titanium nitride-coated femoral component
Hip resurfacing preserves femoral bone but the procedure has been limited by technical difficulty, health of the preserved bone, and wear and fixation of the bearing surfaces.1–5 Resurfacing patients have a lower incidence of mortality at 10 years compared to patients undergoing total hip replacement (THR)
This was a gathering of experienced and enthusiastic hip resurfacing surgeons from mostly the US, but a couple of surgeons from Europe. It was nice to see that Smith and Nephew put forth the resources to get us together. Since it was a S&N meeting, the results and emphasis were on the Birmingham Hip Resurfacing, the first of which was performed in 1997!
This lecture titled "BHR and Other Options" has been released by Derek McMinn as a tribute to Vicky Marlow, owner and founder of this site who was a fantastic voice and advocate for hip resurfacing. Vicky worked tirelessly with hundreds of patients about the benefits of hip resurfacing.
We have received a number of inquiries in our office regarding the merits of cemented versus non-cemented femoral head components in hip resurfacing arthroplasty.
If an HRA has failed, I try to solve the problem by revising only the acetabular component whenever possible because HRA are functionally better than THR. If only the acetabular component is revised, the patient still has a HRA. If the femoral component is revised, the patient now has a THA.
Metal-on-metal (MoM), ceramic-on-ceramic (CoC), and ceramicized metal-on-polyethylene (CMoP) bearings all were developed as a reaction to the well recognized mediocre long-term results with metal-on-polyethylene hips in younger, more active patients.
A recent opinion posted on surface hippy correctly pointed out that women have a higher risk than men. However this is changing as we learn the nuances of hip resurfacing and improve our techniques. Some surgeons avoid women; in my practice odds of success are now virtually the same in women and men. When making a decision regarding hip resurfacing
A recent Article in the Lancet medical journal has criticized hip resurfacing arthroplasty (HRA) as less durable than cemented 28mm total hip replacement (THR). I take exception to the inappropriate conclusion that the authors drew from this highly flawed study.
We read with interest the comments attributed to you by Deborah Cohen in her piece1 in the British Medical Journal on the 28th of February 2012, that this is one very large uncontrolled experiment exposing millions of patients to an unknown risk. These comments are being quoted as first principles by the newspapers and law firms around the world.
I would like to take this opportunity to comment on the Lancet article, Failure rates of metal-on-metal hip resurfacings: analysis of data from the National Joint Registry for England and Wales, by Professor AW Blom, published on October 2, 2012.
There have been several press reports regarding the new MHRA (Medicines and Healthcare products Regulatory Agency) guidelines on metal-on-metal (MoM) hip replacements. We have had a number of enquiries from concerned patients.
Problem is, if no innovation at all is tried, how do we make progress? McMinn was way more responsible than most innovators and went to great lengths to iron out any 'bugs' in the BHR before he released it to open market.