Artificial Hip Replacement John Donahoe What is it

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Artificial Hip Replacement John Donahoe

Artificial Hip Replacement John Donahoe

What is it? • Hip Replacement Surgery is the most common orthopedic procedure today

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.

Components • Acetabular Cup • Femoral Component • Articular Interface • Hemiarthroplasty – Femoral

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

Reasons for Arthroplasty • Osteoarthritis, rheumatoid arthritis, avascular necrosis, traumatic arthritis, hip fractures, bone

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

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

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

Materials (Cont. ) • Plastic – Polyethylene – UHMWPE (Ultra High Molecular Weight Poly.

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

Positives & Negatives • Ceramic – Strong, non-corrosive, agrees with body (Vitamin E) –

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

Approaches • • Posterior Lateral Antero-lateral Minimally Invasive – Smaller incisions, less scarring, limits

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

Results and Complications • Roughly 120, 000 annual hip replacements in the U. S.

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)

Health Risks • • • Infection Blood Clots Leg-Length Inequality Dislocation Corrosion – Metallosis

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

Recalls • De. Puy ASR XL • De. Puy ASR hip resurfacing system •

Recalls • De. Puy ASR XL • De. Puy ASR hip resurfacing system • Stryker Rejuvenate • Stryker ABGII • Smith and Nephew R 3 Acetabular System

Moving Forward • Alternate Materials – Ivory • Dr. San Baw (300 procedures from

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

Sources • • http: //bonesmart. org/hip-replacement-implant-materials/ http: //en. wikipedia. org/wiki/Hip_replacement#Metal-onmetal_hip_implant_failure http: //www. sullolaw. com/productdefects/hip-metallosis.

Sources • • http: //bonesmart. org/hip-replacement-implant-materials/ http: //en. wikipedia. org/wiki/Hip_replacement#Metal-onmetal_hip_implant_failure http: //www. sullolaw. com/productdefects/hip-metallosis. aspx? kid=97 C 4 CB 9 C -64 C 8 -48 B 5 -8 A 0908305 B 53 E 9 B 1&ad=24761454863&kw=%2 Bmetallosis&source=adwords& campaign=Top-Metallosis-Keywords&gclid=CKHe 6 Ts 0 Lk. CFVOe 4 Aod. XFo. ADQ http: //www. stryker. co. uk/index/st_pag_patients-home/st_pag_patientship/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=a 00377 http: //www. rightdiagnosis. com/h/hip_replacement/stats. htm