Russell Meldrum, MD Indiana, University, School of Medicine, Department of orthopedics 550 North University Blvd., Room 1250 Indianapolis, IN 46202 317-274-7359.

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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