Hip resurfacing has become a real dilemma for the patient and the orthopedic surgeon in the United States. The attraction for the patient is minimum bone resection and maximum performance. And when they work, resurfacing really works as advertised, coming closer to restoring normal joint function than anything artificial yet developed for the hip. Data supporting its use leading to FDA approval in 2006 came from a single surgeon’s series of patients in England who invented the prosthesis…the Birmingham Hip Resurfacing System. In 2007, the Cormet was also released based on multicenter U.S. data and quickly joined the BHR in attracting surgeon advocates and patient disciples because of the Resurfacing recipient ability to return to sports at the highest level of performance while post hip resurfacing, the laborer returned to work without restriction.
Recently, a report was presented by surgeons at Rush University Medical Center in Chicago about problems with the new Birmingham Hip System. They observed that women had a higher failure rate than men and needed “a second corrective operation soon after the first compared to women who get a conventional full hip replacement”. They reported these complications were more frequent in women of all ages and in men over the age of 55 years…concluding “this procedure is not ideal for everyone”. The operation worked best in younger men. Their results confirmed that about “6% suffered serious complications in the first year after the procedure”…and about half of those patients needed another operation, a conventional total hip.
One common problem after surface replacement of the hip in women was a fracture of the proximal portion of the femur…which some surgeons attribute to osteoporosis. You might think a bone density test would be conclusive in determining if a woman were a candidate for hip resurfacing procedure…but the data is not sufficient and surgeons are not in agreement. So now what? As a surgeon, I certainly do not want to cause an increased risk of complication when I undertake elective surgery. On the other hand if I were the patient, I would want all the potential benefits of a large femoral head, a metal on metal bearing surface and a minimal resection of bone so I could continue my interests in ultimate skiing, mountain and rode biking, and fly fishing in a rocky stream, without concern.
Enter the next dimension in prosthetic design, a prosthesis that incorporates new design features to address the growing demand for bone conserving and minimally invasive options in total hip arthroplasty. The Microplasty and Short Citation designs offer a 90mm length stem as contrasted with the standard 135 to 145mm length femoral stem. There is flexibility allowed to offer a large metal on metal bearing surface or a ceramic on cross-linked polyethylene bearing surface. So for all the benefits of Hip Resurfacing with out the potential risks, speak with your surgeon about the new bone sparing but risk adverse hip implant

For more information, please go to www.drsheinkop.com.