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Artificial Hip Replacement

Artificial Hip Replacement. John Donahoe. What is it?. Hip Replacement Surgery is the most common orthopedic procedure today Orthopedics

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Artificial Hip Replacement

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  1. Artificial Hip Replacement John Donahoe

  2. What is it? • Hip Replacement Surgery is the most common orthopedic procedure today • Orthopedics • The branch of medicine that deals with the prevention or correction of injuries or disorders of the skeletal system and associated muscles, joints and ligaments.

  3. Components • Acetabular Cup • Femoral Component • Articular Interface • Hemiarthroplasty • Femoral Head • Total Hip Arthroplasty

  4. Reasons for Arthroplasty • Osteoarthritis, rheumatoid arthritis, avascular necrosis, traumatic arthritis, hip fractures, bone tumors (benign and malignant).

  5. Materials • 4 Common types • Metal-Metal • Metal-Plastic (longest used) • -Ceramic-Plastic • Ceramic-Ceramic

  6. Materials (Cont.) • Plastic • Polyethylene • UHMWPE (Ultra High Molecular Weight PolyEthylene) • Metal • cobalt chromium alloy, titanium alloy, sometimes stainless steel

  7. Positives & Negatives • Ceramic • Strong, non-corrosive, agrees with body (Vitamin E) • Most expensive, can be squeaky and sometimes breakable • Metal • Large ball head; provides greater range of motion and lower chance of dislocation, least pricey • High chance of corrosion • Plastic • More expensive than metal, less than ceramic, durable • Semi-corrosive, body does not agree with plastic corrosion

  8. Approaches • Posterior • Lateral • Antero-lateral • Minimally Invasive • Smaller incisions, less scarring, limits vision, may require special x-ray equipment

  9. Results and Complications • Roughly 120,000 annual hip replacements in the U.S. • Incidence rate is about 1 in 2,266 operations or ~0.04% • Most adverse effects stem from metal corrosion (about 0.01 mm per year)

  10. Health Risks • Infection • Blood Clots • Leg-Length Inequality • Dislocation • Corrosion • Metallosis (Metal) • Osteolysis (Plastic or Metal) • Pseudotumors • Necrosis

  11. Recalls • DePuy ASR XL • DePuy ASR hip resurfacing system • Stryker Rejuvenate • Stryker ABGII • Smith and Nephew R3 Acetabular System

  12. Moving Forward • Alternate Materials • Ivory • Dr. San Baw (300 procedures from 1960-1980, 88% success, all ages 24-87, physical activity) • Carbon Fiber? • Ceramic development

  13. Sources • http://bonesmart.org/hip/hip-replacement-implant-materials/ • http://en.wikipedia.org/wiki/Hip_replacement#Metal-on-metal_hip_implant_failure • http://www.sullolaw.com/productdefects/hip-metallosis.aspx?kid=97C4CB9C-64C8-48B5-8A09-08305B53E9B1&ad=24761454863&kw=%2Bmetallosis&source=adwords&campaign=Top-Metallosis-Keywords&gclid=CKHe-6Ts0LkCFVOe4AodXFoADQ • http://www.stryker.co.uk/index/st_pag_patients-home/st_pag_patients-hip/st_pag_patients-hip-replacement.htm • http://www.minfirm.com/nj-pa-depuy-recall-attorneys-defective-replacements-signs-symptoms • http://orthoinfo.aaos.org/topic.cfm?topic=a00377 • http://www.rightdiagnosis.com/h/hip_replacement/stats.htm

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