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Hip
resurfacing is intended for young, active adults who are under 60
years of age and in need of a hip replacement. Adults over 60 who are
living non-sedentary lifestyles may also be considered for this
procedure. However, this can only be further determined by a review of
your bone quality.
There
are certain causes of hip arthritis that result in extreme deformity
of either the head of the femur or the acetabulum (hip socket). These
cases are usually not candidates for hip resurfacing.
Talk
with your orthopaedic surgeon to determine if hip resurfacing is the
right option for you.
The Implant
The
BIRMINGHAM HIP Resurfacing implant is not brand new. It has been in
use around the world since 1997 and has since been implanted more than
60,000 times. It is new to the United States, however, where it was
approved for use by the Food and Drug Administration in May 2006.
Although hip resurfacing is not a new concept, the technology behind
the ground-breaking BIRMINGHAM HIP was developed by British orthopedic
surgeons Mr. Derek McMinn and Mr. Ronan Treacy. The two surgeons now
train orthopedists from around the globe on behalf of London-based
medical device manufacturer Smith & Nephew. US surgeons given access
to this implant may travel to England for specialized training or may
train at one of the few US centers capable of hosting these focused
sessions.
The benefits to patients of the BIRMINGHAM
HIP Resurfacing technique and implant are clear. The implant’s head
size, its bearing surfaces, and its bone-sparing technique make it a
preferred choice for young, active patients. While the implant’s rate
of survivorship is comparable to standard total hip replacements after
five years, these three key advantages set the resurfacing technique
and implant apart from its total hip replacement counterparts.
The most noticeable aspect of this
implant is its size. While it closely matches the size of your
natural femoral head, it is substantially larger than the femoral
head of a total hip replacement. This increased size translates to
greater stability in your new joint, and it decreases the chance
of dislocation of your implant after surgery. |
Healthy hip > BHR implant > Total
hip |
BIRMINGHAM HIP Resurfacing takes advantage of
one of the orthopaedic medical industry’s most technologically
advanced bearing surfaces. That means that the surfaces of the
ball and the socket are made from materials that dramatically
reduce joint wear when compared to traditional hip implant
materials. |
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In this case, both the ball and socket are made from tough, smooth
cobalt chrome metal. Traditionally, only the ball is made from
cobalt chrome, and the socket is lined with a plastic cup. While
this plastic cup has some design advantages, it does wear out over
the course of many years since it rubs against the metal ball at a
rate of nearly two million footsteps per year in physically active
adults.
The plastic particles released into the area around the joint as a
result of this plastic wear can lead to a condition called
osteolysis, which causes the bone around the implant to soften,
become unstable, and ultimately a corrective surgery and new
implant are required.
However, when both surfaces of a hip implant are made from cobalt
chrome, wear particles are reduced by 97-percent1, thus
potentially extending the life of the implant.
There may be risks associated with metal-on-metal hip implants,
though. While no evidence has been established on the subject,
some are concerned that the increased level of metal ions found in
the blood of metal-on-metal hip recipients may have negative
effects on the human body. For this reason, some surgeons may not
implant such a device in a patient with kidney disease (since
healthy kidneys filter ions from your body) or in women who are or
may become pregnant. |
Perhaps the greatest benefit of the
BIRMINGHAM HIP Resurfacing implant is the fact that it conserves
substantially more bone than a total hip replacement. This is
important for two key reasons.
First, unlike a
total hip replacement, the BIRMINGHAM HIP Resurfacing preserves
your natural femoral neck. It is this neck length and angle that
determines the natural length of your leg, and since it is not
removed and replaced with an artificial device during a
resurfacing procedure, concerns regarding leg length discrepancy
are virtually non-existent.
Second, if your surgeon should determine you need to have your
BIRMINGHAM HIP implant replaced at some point in the future, you
may undergo a regular total hip replacement surgery. If you had
originally undergone total hip replacement instead of hip
resurfacing, you would be dealing with a more traumatic and
complex procedure and you would be receiving a more invasive
implant. |
BHR cuts > Total hip cuts |
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The Procedure
Until just recently, your orthopedist would likely be
recommending total hip replacement surgery at this point of your
disease state. While it is clearly a more bone-sacrificing
procedure than hip resurfacing, total hip replacement is a safe
and effective surgery, and is performed more than 300,000 times
per year in the United States.
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Hip before
surgery |
Implant
components |
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 As you may know, total hip
replacement requires the removal of the femoral head and the
insertion of a hip stem down the shaft of the femur. Hip
resurfacing, on the other hand, preserves the femoral head
and the femoral neck. During the procedure, your surgeon
will only remove a few centimeters of bone around the
femoral head, shaping it to fit tightly inside the
BIRMINGHAM HIP Resurfacing implant.
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Your surgeon will also prepare the acetabulum for the metal cup
that will form the
socket portion of the ball-and-socket joint. While the resurfacing
component slides
over the top of the femoral head like a tooth cap, the acetabular
component is pressed
into place much like a total hip replacement component would be.
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BIRMINGHAM
Hip Resurfacing System
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While the BIRMINGHAM HIP Resurfacing
implant is new to the United States, it is not a new implant
or technique. It has been in use worldwide since 1997, and the US
Food and Drug Administration
reviewed a tremendous amount of resulting clinical data before
approving it for use in this country.
The typical patient will be physically
active, under 60 years of age, and suffering from hip arthritis,
hip dysplasia or avascular necrosis of the hip.
The implant can be used in patients over 60 whose bone quality is
strong enough to support the implant.
Your surgeon will make the determination if you are a candidate
for hip resurfacing.
It is impossible to say how
long your implant will last because so many factors play into the
lifespan of an
implant. In the case of resurfacing, for instance, the
metal-on-metal bearing surfaces of your new joint may
extend its life longer than that of a traditional total hip
replacement, but failure to comply with your physical
rehabilitation regime may cause your implant to fail within
months. A clinical study showed the
BIRMINGHAM HIP Resurfacing implant had a survivorship of
98.4-percent at the five-year mark, which is
comparable with the survivorship of a traditional total hip
replacement in the under-60 age group.
Your surgeon will use an incision of between six and eight inches
in length. While some
surgeons may use a slightly smaller incision, most will fall in
that range.
Most surgeons will tell you that after the first year, you can
return to
whatever physical activity you enjoyed before hip pain limited
your mobility. For instance, unlike total hip replacement,
you will be able to return to jogging or singles tennis after your
first year after surgery. During your first year, more
conservative, low-impact activities like walking, swimming and
bicycling are recommended for strengthening your
femoral neck and the muscles around your resurfaced joint.
Ask your surgeon for BIRMINGHAM HIP Resurfacing
System patient information, or visit
www.BirminghamHipResurfacing.com.
*Trademark of Smith & Nephew. |
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