|
99.8% survivorship at 3.3
years
|
|
95.7 % at 8 years |
| 99.5% of these patients
were happy at 5 years. |
| 3227 were male, 1602
female, there were 50 revisions, 14 were
fractures, 14 collapsed neck |
|
95.7% satisfied at 8 years
|
|
The 1.5% neck fracture -
due to learning curve.
|
Australian National Joint Registry
|
Resurfacing hip systems requiring
revisions 1999 - 2007 |
|
BHR device implantation in Australia
started in 1999 |
|
Competitors devices started in 2000/2001 |
|
Resurfacing Product |
Number revised |
Total Number |
% Revised |
Observed Component years |
Revisions per 100 observed component
years |
|
ASR |
31 |
753 |
4.1 |
1042 |
3 |
|
BHR |
166 |
6773 |
2.5 |
19585 |
0.8 |
|
Conserve Plus |
4 |
59 |
6.8 |
134 |
3 |
|
Cormet 2000 |
8 |
95 |
8.4 |
288 |
2.8 |
|
Durom |
25 |
564 |
4.4 |
927 |
2.7 |
|
Recap |
2 |
50 |
4 |
81 |
2.5 |
These numbers were all from the Australian Hip
Registry which was
established in 1999. A total of 140,018 patients
registered with
160349 procedures out of which 8361 were
resurfacings.
The BHR was started in 1999 and the competitors
started in 2000 and
2001. This is the latest data published in that
registry. I am sure
there are more details in the registry itself,
but this is all the
data, well minus 1% of resurfacing done in
Australia. I think it is
somewhat a good overall feel for the results
considering it is
gathered over almost the same amount of time,
from all of Australia
in all patients given the procedure which would
cover all doctors, etc.
Some important points made
at the conference.
It is imperative that the
newer doctors pick IDEAL candidates ONLY
*My note: If you have a very
straight forward case, then you can decide if it
is worth the risk of going to a newer less
experienced surgeon but if you have any
complications at all, dysplasia, cysts, AVN,
pick an experienced resurfacing surgeon*VM
Slipped Cups
Slipped cup question came
up during Dr. Su's live surgery video with two
way audio. Dr. Su has not had one slipped cup
in over 400 procedures to date, he stated that
if a cup is seated properly it will not shift or
slip. McMinn wanted to make it clear that the
focus to date was on the placement of the
femoral component but more care needs to be made
on the acetebular cup side and the importance of
this as well.
Age and Sex of
Preferred Patients
I asked
individual doctors the question about age.
Some will cut off at 55 for women, others
will look at individual cases. *I really
do not like when they use age as a
determining factor without looking at all
other aspects of a patient including bone
density, health, activity level, etc.*VM
Overall
the majority of failures seemed to happen in
women, so they were saying ideal candidate
were men, so the newer docs will probably be
more selective with the women patients.
Negative factors for
not performing resurfacing were:
They
also found that AVN cases tended to have
about 8 - 10 % lower survivorship at 10
years than OA cases. So, not all docs will
be doing AVN cases.
Metal
Sensitivity
They
didn't actually cover any symptoms a patient
would get. The only time there was mention
of symptoms was during the metal sensitivity
presentation, where they basically stated
that the very rare incidences of unknown
pain that lead to revision was usually due
to the rare incidence of metal allergy.
Out of
6147 hips they had 18 or .05% with
unexplained pain. 11 of 18 retrievals for
pain were suspected sensitivity. So with 11
of thousands implanted, true incidences,
very rare.
Computer Navigation
This
subject was touched on at the conference.
Some doctors do use this but the overall
take on this with Mr. McMinn was that you
can get a much, more accurate placement of
the device without the navigation system.
He implanted several using the computer
navigation and when he measured after, his
personal placements were more accurate. I
know that Dr. Bose also prefers not using
the equipment even though it is available to
him at Apollo Hospital according to his
website.
Conclusions, this might be a good solution
for newer doctors doing hip resurfacing but
the more experienced docs actually get more
precise placement not using computer
navigation.
