Hip resurfacing

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Pelvic coating has been developed as a surgical alternative for total hip replacement (THR). This procedure consists of placing a cobalt-chromed, hollow-shaped, cobalt-shaped metal cover on the head of the femur while a suitable metal cup (similar to what is used with THR) is placed on the acetabulum (pelvic socket), replacing the articulation surface of the hip joint patients and removing very few bones compared to THR. When the patient moves the hip, the joint movements induce a synovial fluid to flow between the hard metal bearing surfaces that lubricate them when the component is placed in the correct position. The experience level of the surgeon with hip coating is the most important; Therefore, the selection of the right surgeon is essential for a successful outcome. Measurements of quality of life associated with real health are increased and patient satisfaction is profitable after hip resurfacing.

Video Hip resurfacing

Advantages and disadvantages

Potential benefits of hip coating compared with THR include fewer bone reductions (bone preservation), the possibility of a decrease in pelvic dislocation due to the relatively larger size of the head of the femur (given that the patient has anatomical femur head size), and easier revision surgery. for each subsequent revision to the THR device as the surgeon will have more original available bone stock The potential weakness of hip coating is femoral neck fracture (velocity 0-4%), aseptic decay, and metal wear. Due to complete patient femoral neck retention there are other advantages that exist: The spike in differences caused by doctors in leg length (as can happen with THR) is now minimized. Also, toe-in or toe-out errors that can occur interoperatively with THR now terminate because the femoral neck that determines the direction of the foot is left undisturbed by hip resurfacing.

On February 10, 2011, the US FDA issued a patient advisor on the implants of the hip metals, stating that it continues to collect and review all available information about metal-in-metal hips systems. On 27-28 June 2012, the advisory panel meets to decide whether to enforce the new standard. No new standards, such as routine checks of blood metal ion levels, are established, but guidelines are updated.

Maps Hip resurfacing

Patient choice

The patient's suitability for hip resurfacing is determined by the patient's anatomy and the patient's surgeon. Hip coating is intended for younger patients who are not morbidly obese, are clinically eligible for hip replacement (prescribed by a doctor), have been diagnosed with noninflammatory degenerative joint disease, have no infection, and are not allergic to metals used in the implant. Hip coating should not be used in patients with severe bone loss in their femoral heads, those with large femoral neck cysts present (usually found in surgery) or cysts close to the head neck joint, or patients with poor bone stock or osteoporosis. Caution should be used for patients who have high, thin, or boned rheumatoid arthritis, those with osteonecrosis (poor blood supply) to the femoral head, or those with femoral head cysts & gt; 1 cm on the x-ray taken before surgery. Metal-in-metal coating systems are generally unsuitable for women of childbearing age due to the unknown effects of metal ion release on the fetus. Patients with any of these conditions may not be suitable candidates for pelvic coating. There is a pelvic coating component which has a ceramic coating on the metal femoral head component and a crosslinked polyethylene plastic as a liner for the socket or cup area so that it is not metal on the metal.. Plastic arm can be replaced if needed without removing the main components. Not all surgeons use this but so far the best of causing metallosis. A surgeon using this method is (Dr James Pritchett; Orthopedic Swedish Seattle Wa. He has performed over 5200 hip loosening)

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Device

In 2006, the United States FDA approved a hip coating using the Birmingham Hip Resurfacing (BHR) system, designed by British Orthopedic surgeon Derek McMinn. All other FDA approved devices have been removed from the US Market. BHR is no longer recommended for use in women. However, it would be the best choice for young men with osteoarthritis, according to the Australian National Joint Replacement Registry, reporting that for men under the age of 55 with osteoarthritis, Birmingham Hip Resurfacing is the best performing of all types of hip replacements in Australia. There are several other manufacturers of hip coating systems, especially in Europe. Another THR and hip resurfacing system, DePuy ASR, which has undergone clinical trials for hip coatings in the United States and marketed overseas, has been recalled for being shown to have an abnormally high rate of revision. Therefore, a prospective patient needs to be careful to make sure the type of device used has an acceptable track record. The subtle differences between devices in terms of design, manufacturing and surgical techniques can prove to be detrimental to clinical success.

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Procedures

The hip coating device is a different metal-metal loudspeaker device than the total hip replacement device because they are more preserving bones and retain natural geometry (called big ball THR devices sharing these properties). THR requires that the upper part of the femoral bone is cut to receive the stem part of the THR device. The femur cap of the hip resurfacing device does not require a cut thigh bone; instead the top of the femoral head is formed to fit the bottom of the cap. Both hip replacement and hip replacement require that the cup be placed on the acetabulum of the hip socket. The main advantage of surgical hip resurfacing is that when revisions are needed, there is still a whole femur bone left for the THR stem. When the THR rod requires revision, the metal rod in the femur should be removed and often more bones are lost in the removal and replacement process with larger diameter rods. Having a resurfacing hip at a younger age means that revisions will likely be easier when needed.

Recent studies have shown that the result of hip coating depends on the surgeon's experience and the exact position of the pelvic coating component is very important. Therefore, in addition to ensuring that the device is proven to be used, patients should be careful in choosing a surgeon with good experience and track record.

Although formal label restrictions exist in some countries, including the United States, hip coating allows younger and more active people to return to the many activities they enjoy before their hip problems, which is an advantage over traditional hip artoplasti. The large size cap and the hip coating device cups have the same size as the original ball and socket and are thus less susceptible to dislocations.

The often overlooked but very important advantage of hip coating and thus femoral neck retention is the fact that hip coating has the least measurable "protective tension" when compared with THR types. This means that with the hips resurfacing the top of the femur completely maintaining the natural mechanical characteristics under the load, it also ensures less disturbance of the processes occurring within the living bone.

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Famous athlete

There are many athletes with hip resurfacing who continue to compete on a personal and professional level in various activities. They include:

• Kay Glenn, winning a leap high in the senior national Olympics. http://issuu.com/orlandolife/docs/gb_nov-dec13/27? e = 6499479/5415221
• Ron Noreman, who on July 24, 2010 won the NPC Empire States Bodybuilding Championship Masters Division just 5 months after hip pelvic surgery.
• Cory Foulk, who completed the marathon three months after his surgery, and finished 11th at the Ultraman world championship eleven months later
Ian MacLaren, of the Torashin Karate Club, is believed to be the first and fifth karate-ka in the world to have both hips reappear to the surface of Slater Williams 7th And Shotokan Karate has both hips reappearing from 1999 to 2000
• Floyd Landis, winner of the 2006 Tour de France (until disqualified). The procedure is done after the Tour wins.
• Joe Tierney finishes the Syllamo's Revenge 50 km, 2011, 2012, and 2013 races, each with 18, 30 and 42 month endurance, after reflecting operations on his left hip. This singletrack course through the Ozark Mountains has been designated an "epic" by the International Mountain Bike Association.
• Ed (JovoCop) Jovanovski NHL Player - Defense Florida Panthers. Just 9 months after the procedure, Ed returns to the NHL. He is the first athlete to return to the main professional sports team after the procedure is completed.
• Chase Poulsen - Olympic champion Tae Kwon DO. Return to athlete training only 6 months after the procedure.
• Colby Lewis, MLB pitcher. Seven months after the procedure, Colby returned to baseball. He became the first player to return to MLB after hip coating.
• Gene Nelson from Aikikai Florida (Aikido) 5th Dan. The hip of the bilateral hip appears again. 2005 and 2009.

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Call back

In August 2010, DePuy Orthopedics, Inc., issued a voluntary withdrawal from ASR (TM) XL Acetabular System and ASR (TM) Hip Resurfacing System after new information from the British National Joint Registry showed that the number of patients requiring both hip replacement procedures, called revision operations, is higher than previously reported data. Potential complications include pseudotumors, metallosis, ALVAL (Aseptic Lymphocytic Vasculitis Associated Lions), and femoral neck fractures.

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See also

• Minimally invasive hips coating
• Total Hip Replacement

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References

Source of the article : Wikipedia