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Russell Meldrum, MD. Indiana, University , School of Medicine, Department of orthopedics. 550 North University Blvd., Room 1250. Indianapolis, IN 46202. 317-274-7359. Named for Birmingham, England, where the device’s creators practice medicine
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Russell Meldrum, MD Indiana, University , School of Medicine, Department of orthopedics 550 North University Blvd., Room 1250 Indianapolis, IN 46202 317-274-7359
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. Overview
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 Who is the typical candidate for BHR*System?
Socket Ball Femoral neck Smooth weight-bearing surfaces Smooth cartilage Femur Anatomy
“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 Osteoarthritis (OA)
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 Hip 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
Lifestyle modification Exercise and physical therapy Anti-inflammatory medication Non-surgical alternatives
Risks • Thromboembolism • Infection • Pneumonia
Conventional hip replacement Healthy hip Cuts Implant components Implanted
The BHR*System Healthy hip Cuts Implant components Implanted
Conventional vs. the BHR*System Total hip cuts BHR System cuts
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 That depends on how you define “Minimally Invasive.”
Head size Advanced bearing surface Bone conservation The key benefits
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) Head size Total hip head BHR head Healthy head
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 Plastic Metal Advanced bearing surface
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 conservation Hip with osteoarthritis Bone cuts fora traditionalhip replacement Bone cuts forBHR System
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 Bone conservation (cont.)
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) After surgery
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