Russell Meldrum, MD Indiana, University, School of Medicine, Department of orthopedics 550 North University Blvd., Room 1250 Indianapolis, IN 46202 317-274-7359.
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Russell Meldrum, MD
Indiana, University , School of Medicine, Department of orthopedics
550 North University Blvd.,
Room 1250
Indianapolis, IN 46202317-274-7359
Overview
• Named for Birmingham, England, where the device’s creators practice medicine
• Used globally since 1997; More than 65,000 implanted
• Approved by the FDA in March 2006
• In an international study of 1,626 hips, 99.5% of patients were “Pleased” or “Extremely Pleased” with the results of the BIRMINGHAM HIP Resurfacing (BHR) System.
Who is the typical candidate for BHR* System?
• Adults under age 60 for whom total hip replacement may not be appropriate due to an increased level of physical activity
• Active adults over age 60 may be candidates, depending on their bone quality
Anatomy
Socket
Ball
Femoral neck
Smooth weight-bearing surfaces
Smooth cartilage
Femur
Diseases of the hip
Osteoarthritis (OA)
• “Wear and tear” arthritis• Joint becomes pitted, eroded,
uneven…and painful• Bone spurs, or osteophytes,
often form• The common activities of
daily living become limited by extreme pain
Hip dysplasia
• Congenital disease that affects 1 in 1,000 people
• The hip doesn’t develop the normal wear patterns, which leads to early OA
• Chief risk factor: family history
• Women, first-born children and breech babies have higher rates of dysplasia
Avascular necrosis (AVN)
• Caused when there is a disruption of the blood supply to the hip
• In time, the bone will die and the femoral head will collapse
• Leading causes: Alcoholism, corticosteroids• Other risk factors: blood vessel blockage due
to sickle cell anemia or fat particles, or from dislocation of the hip due to trauma
Non-surgical alternatives
Non-surgical alternatives
• Lifestyle modification• Exercise and physical
therapy• Anti-inflammatory medication
Risks
Risks
• Thromboembolism• Infection• Pneumonia
The procedure
Conventional hip replacement
Healthy hip Cuts Implant components Implanted
The BHR* System
Healthy hip Cuts Implant components Implanted
Conventional vs. BHR* Resurfacing
Conventional vs. the BHR* System
Total hip cuts BHR System cuts
Is it minimally invasive?
That depends on how you define “Minimally Invasive.”• Soft Tissue
– No. Incision length of 6 to 8 inches
• Bone– Yes. Preserves your
body’s natural bone structure; It resurfaces rather than replaces
Conserved bone
The implant
The key benefits
• Head size• Advanced bearing surface• Bone conservation
Head size
• Closely matches the size of your natural femoral head
• Larger than the head of a total hip replacement
• Larger head means a reduced chance of dislocation after surgery—a leading cause of revision surgery
– 1-3% of total hips dislocate over the lifetime of the implant
– 0.3% of BHR* implants dislocated in the first 5 years after surgery (in a study of 2,385 hips)
Healthy headBHR headTotal hip head
Advanced bearing surface
• Metal-on-metal implant• No plastic liner like most total
hip replacements• All-metal total hip
replacements reduce joint wear by 97% versus metal on plastic total hips; BHR* implants were found to be in this range
Metal
Plastic
Hip with
osteoarthritis
Bone cuts for
a traditional
hip replacement
Bone conservation
• Preserves your natural femoral neck– Neck length and angle
determine accurate leg length
– With the BHR* System, you retain your original equipment; with a total hip, your femoral neck is replaced by the implant
Bone cuts for
BHR System
Bone conservation (cont.)
• Revises to a primary– If you need “revision”
surgery, you don’t get a revision implant
– The follow-up procedure would be the same total hip replacement you would otherwise have received
After surgery
After surgery
• You will undergo a rehabilitation protocol similar to total hip replacement patients
• During year-one: Low-impact activities as your bone and muscles adjust to the new stresses (swimming, walking, bicycling)
• After year-one: Higher impact physical activity may be appropriate (singles tennis, jogging)
Q&A
www.BirminghamHipResurfacing.com
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