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Dr. Rogerson video interview by Vicky Marlow
Freelance Patient Advocate Volunteer 2008
Dr. Rogerson Video Interview about Hip Resurfacing
Hi Vicky,
It was great to finally meet you also. I was impressed with your knowledge base
and interest level. Good to hear from you and it was a lot of fun getting to
know you at the Miami conference. Your synopsis was right on and the pictures
were great. As far as the questions go:
1.) Why do you choose to use the posterior approach over other approaches?
The most important reason I use the posterior approach is to spare the gluteus
medius and avoid an abductor lurch after surgery which is fairly common with a
lateral, antero-lateral and to a lesser extent anterior approach. Patients who
desire to get active again are very dissatisfied if they have abductor weakness;
if you detach a portion of the gluteus medius then you really have to protect
its repair for 6 or so weeks after the surgery as Paul Beaule does. Another
reason I like the posterior approach is the exposure one can attain for the
femoral head and the ability to effectively use the stylus to get the guidewire
in exactly the right position.
2.) How long do you feel it takes for the bone to be fully healed, grow into the
prosthesis? What is the recommended time you tell your patients before they can
start to run again/do impact sports?
I think it takes 6-8 weeks for the bone to effectively grow into the acetabular
component but I restrict high impact activities longer than that to avoid stress
fracture in the femoral neck in patients that have not been able to be active
for some time. if the patient has forced themselves to be impacting right up to
the time of surgery like Gary then I would let them get back sooner. In general,
I hold off the patient from high impact heel strike for 4-6 months post-op. They
can run in a pool and jump rope sooner. Each case is individualised based on the
patient's bone quality at the time of surgery.
3.) What is your take on cementless devices.
I think the presentation and the xrays shown by Dr. Papavasileou were very
telling. Many of the xrays showed significant neck narrowing not seen on the
cemented BHR xrays. I think this is because the ingrowth on the cementless heads
is "spotty" and leads to variable stress shielding of the distal inferior neck
and calcar bone. Some of the xrays were very ominous appearing and will likely
result in delayed neck fracture. Therefore, I will stay with the thin cement
mantle produced by the BHR technique to spread out the forces coming down the
femoral neck and avoid the stress shielding.
4.) Which resurfacing device do you prefer to use?
I definitely prefer the Birmingham prosthesis compared to the others on the
market. This relates to the metallurgy with the as cast large block carbides and
better wear than the heat treated metals, the precise instrurnentation and the
line to line fit of the femoral component, and the truly impressive results at
10 year follow-up.
Hope this covers the issues. Again, great to see you finally at the meeting.
Your friend,
John Rogerson
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