Hip resurfacing: a technology reborn

Cutts, Steven; Carter, Paul B

doi:10.1136/pgmj.2005.044594

Cited by 12 publications

(6 citation statements)

References 40 publications

(19 reference statements)

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“…As patients receiving THA are increasingly (biologically) younger and active, the development of less invasive approaches and bone preserving solutions has been a key focus during the last decade [8,9]. HR has emerged as a promising way of sparing bone, while retaining the biomechanics of the hip joint and potentially allowing a facilitated revision, if necessary [10,11]. However, concerns about wear and longevity have arisen in the process [12,13].…”

Section: Introductionmentioning

confidence: 99%

Trends in Total Hip Arthroplasty in Germany from 2007 to 2016: What Has Changed and Where Are We Now?

et al. 2019

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Background The number of total hip arthroplasties (THA) is rising in many industrialized nations. At the same time, the evidence regarding different types of prostheses and fixation techniques is constantly evolving. Therefore, this study aimed to analyze changes in THA by these advancements during the last decade. Methods A retrospective analysis of data provided by the Federal Statistical Office of Germany from 2007 to 2016 was conducted using codes from the German procedure classification system and associated International Statistical Classification of Diseases and Related Health Problems codes. THA procedures were evaluated according to diagnoses, sex, and age of patients, along with the distribution of different prosthesis types. Additionally, changes in these parameters over time were analyzed. Results From 2007 to 2016 a total of 2 157 041 primary THA procedures were performed in Germany, with an increase of 14.4% over this period. Overall, cementless standard THA (STHA) was used most frequently (50.0%), followed by hybrid variants (18.8%), hemiarthroplasties (15.9%), cemented standard THA (cSTHA; 9.2%), cementless short-stem THA (ssTHA; 4.8%), and hip resurfacing (HR; 0.9%) techniques. During the study period, the number of cSTHA and HR decreased significantly, whereas the use of STHA and ssTHA rose substantially, with a significantly higher application of these procedures in the elderly population. While osteoarthritis of the hip joint was the main indication for THA, several procedure-specific differences were identified. Conclusion The present data clearly demonstrate an increase in the use of cementless fixation for THA in Germany during the last decade and document a rise in ssTHA in recent years with, in contrast, the use of HR decreasing to a minimum.

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Section: Introductionmentioning

confidence: 99%

Trends in Total Hip Arthroplasty in Germany from 2007 to 2016: What Has Changed and Where Are We Now?

et al. 2019

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“… 14 Various studies have shown that functional utility of THA reduces to 80% at 10 years, 33% at 16 years, subsequently requiring a revision surgery. Alternate bearing surfaces like metal on metal or ceramic on ceramic decrease the wear rate but have their own set of complications (metallosis, squeaking) 32 33 34 35 36 37 38 39 and long term results are still awaited. 40 When compared with BHA, conflicting results have been reported.…”

Section: Discussionmentioning

confidence: 99%

Bipolar hip arthroplasty for avascular necrosis of femoral head in young adults

Dudani

Shyam

Arora

et al. 2015

IJOO

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Background:Bipolar hip arthroplasty (BHA) is one of the options for treatment of avascular necrosis (AVN) of the femoral head. Acetabular erosion and groin pain are the most allowing for gross motion between the common complications. We propose that these complications are secondary to improper acetabular preparation allowing for motion between the BHA head and the acetabulum.Materials and Methods:The current study retrospectively evaluated patients’records from case files and also called them for clinical and radiological followup. 96 hips with AVN of the femoral head treated with BHA were included in the study. All patients were males with a mean age of 42 years (range 30-59 years). In all cases, the acetabulum was gently reamed till it became uniformly concentric to achieve tight fitting trial cup. Clinical followup using Harris hip score (HHS) and radiological study for cup migration were done at followup.Results:The mean followup was 7.52 years (range 4-16 years). The HHS significantly improved from a preoperative value of 39.3 (range, 54-30) to a postoperative value of 89.12 (range 74-96). According to HHS grades, the final outcome was excellent in 52 hips, good in 28 and fair in 16 hips. Hip and groin pain was reported in four hips (5%), but did not limit activity. Subsidence (less than 5 mm) of the femoral component was seen in 8 cases. Subgroup analysis showed patients with Ficat Stage 3 having better range of motion, but similar HHS as compared to Ficat Stage 4 patients.Conclusion:Bipolar hip arthroplasty (BHA) using tight fitting cup and acetabular reaming in AVN hip has a low incidence of groin pain, acetabular erosion and revision in midterm followup. Good outcome and mid term survival can be achieved irrespective of the Ficat Stage.

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“…The BHR device led the resurgence of interest in MoM hip replacements after being introduced by Midlands Medical Technology in 1997. 13 The BHR is a highly polished, dual radius MoM bearing couple which is said to promote ideal joint lubrication resulting in very low wear rates. 14 This device was buoyed by several successful early short-term studies and became immensely popular in the UK.…”

Section: Mom Devices and Regulationmentioning

confidence: 99%

Balancing innovation and medical device regulation: the case of modern metal-on-metal hip replacements

Howard¹

2016

MDER

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Due to problems with wear particle generation and subsequent loosening using conventional metal-on-polyethylene total hip replacements, there has been a shift toward alternative bearing systems, including metal-on-metal (MoM), for younger, more active patients with degenerative joint disease. Based on positive results from early short-term clinical studies, MoM hip replacements were readily adopted by orthopedic surgeons with thousands being implanted worldwide over the past decade. Unacceptably high revision rates reported by two national joint registries called into question the rigorousness of the regulatory approval process for these implants, particularly with respect to premarket data requirements to prove safety, effectiveness, and the appropriateness of the regulatory pathway chosen. The purpose of this review was to investigate the balance between facilitating the introduction of new medical technologies and the need to ensure safety and effectiveness through comprehensive regulatory assessment. The case of MoM hip replacement devices was used to frame the investigation and subsequent discussions. The regulatory approval processes and post-market surveillance requirements associated with three common MoM hip replacements (two resurfacings: the Birmingham and articular surface replacement and the articular surface replacement XL total hip replacement) were investigated. With respect to modern MoM hip replacement devices, the balance between facilitating the introduction of these new medical technologies and the need to ensure safety and effectiveness through comprehensive regulatory assessment was not achieved. The lessons learned from these experiences have application beyond joint replacements to the introduction of new medical technologies in general, particularly for those who have a significant potential for harm. In this regard, a series of recommendations have been developed to contribute to the evolution of the medical device regulatory process.

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Hip resurfacing: a technology reborn

Cited by 12 publications

References 40 publications

Trends in Total Hip Arthroplasty in Germany from 2007 to 2016: What Has Changed and Where Are We Now?

Trends in Total Hip Arthroplasty in Germany from 2007 to 2016: What Has Changed and Where Are We Now?

Bipolar hip arthroplasty for avascular necrosis of femoral head in young adults

Balancing innovation and medical device regulation: the case of modern metal-on-metal hip replacements

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