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Scott E.
Marwin, MD, FAAOS
- BHR trained Mc Minn 2006
750 Hip Resurfacings to date***
Associate Professor of
Orthopaedic Surgery
NYU/Hospital for Joint Diseases
410 Lakeville Rd., #303
New Hyde Park, NY 11042
T: 516-216-5782
F: 516-216-5786
Website
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Dr.
Marwin's Medical Profile |
What Hip Resurfacing
Device Do You Prefer?
Smith and Nephew Birmingham Hip Resurfacing
Implants (BHR)
What Surgical
Approach Do You Use?
I use the Direct Lateral Approach to the hip.
This is an anterior dislocation. I like the approach because it
increases stability (reduces dislocation), AND provides
excellent exposure of both the acetabulum and femoral head.
Do you have a cut
off age for resurfacing patients or do you go on a case by case
basis?
65 for males. 55 for females. Plus, I will
not resurface a female who is child bearing age. Therefore, the
window for females is very small in my practice. Also, any
female I operate on must have bone densitometry. The study must
be normal.
How do you feel
about cementless devices? Do you prefer cemented and why?
4. What I really prefer is to follow the well developed data
supporting the BHR including fixation techniques. Therefore, I
like the cemented femoral component and the noncemented
acetabular component. This is a technique developed by years of
trial-and-error by McMinn and Traecy. The technique is supported
by data internationally. I’m not interested in any noncemented
femoral fixation.
Does the length of
incision influence the rehabilitation?
I use a standard total hip skin incision of approximately 4 – 5
inches. I do not do MIS (minimal skin incision).
Does the length of incision influence the rehabilitation?
Rehabilitation is NOT affected by skin
incision length in my practice.
Do you preserve the
hip capsule during your hip resurfacing surgeries?
Because I do a direct lateral approach, NO capsule is resected.
In other words, the entire capsule is preserved.
What is your typical
recovery time after resurfacing, what is your typical rehab
protocol? Crutches for ? amount of time? 90 degree restriction?
Functional recovery is actually an individual
issue. However, it is amazing how fast my patients recover
compared to similar patients who have total hip replacements.
Hip precautions including 90 degree restrictions are lifted at 2
weeks following surgery. I start the patient on crutches weight
bearing as tolerated right after surgery. I wean the patient to
a cane then to nothing as fast as possible. I want the patient
off all aides 4 – 6 weeks after surgery. Actually, I want them
driving their car within 3 – 4 weeks after surgery. I want my
patients in outpatient PT as fast as possible. There is no
running or jumping for 6 months to reduce the risk of femoral
neck fracture.
What is your typical
recovery time after resurfacing, what is your typical rehab
protocol? Crutches for ? amount of time? 90 degree restriction?
Functional recovery is actually an individual
issue. However, it is amazing how fast my patients recover
compared to similar patients who have total hip replacements.
Hip precautions including 90 degree restrictions are lifted at 2
weeks following surgery. I start the patient on crutches weight
bearing as tolerated right after surgery. I wean the patient to
a cane then to nothing as fast as possible. I want the patient
off all aides 4 – 6 weeks after surgery. Actually, I want them
driving their car within 3 – 4 weeks after surgery. I want my
patients in outpatient PT as fast as possible. There is no
running or jumping for 6 months to reduce the risk of femoral
neck fracture.
What type of
anesthesia do you use general or epidural or ?
I use general anesthesia because I want the
patient paralyzed to adequately move the lower extremity to get
exposure.
How long do you feel
it takes for the bone to be fully healed, grow into the
prosthesis?
6 weeks for bone to grow into the acetabular
component. 6 months for the femoral neck to adequately remodel
What is the
recommended time you tell your patients before they can start to
run again/do impact sports?
Running and jumping starts at 6 months. None
before 6 months to reduce the risk of femoral neck fractures.
Where did you train
for resurfacing? Who trained you?
I trained in Birmingham, England with Derek
McMinn
A patient can go to
orthodoc.aaos.org/scottmarwin to learn about my practice.
