hip resurfacing in india dr. venkatachalam
DESCRIPTION
Madras Joint Replacement center performs hip resurfacing. Here the history, indications and rationale of the operation is explained.TRANSCRIPT
Hip resurfacing An option for young & active patients with hip disease
Dr.A.K.VenkatachalamFRCS, MCh Orth, MS orth, DNB Orth
Consultant Orthopedic surgeonChennai, Indiawww.hipsurgery.in
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Rationale for Hip replacement & resurfacing Goal of any joint replacement is to
prevent bones without cartilage from grinding against each other.
Rubbing of raw bony surfaces causes pain.
Replacing the joint with a prosthesis abolishes friction and allows smooth & easy movement, removing pain.
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Goals of replacement & resurfacing To allow the patient to return to
many of their normal activities without pain and greater freedom of movement
To prevent further morbidity
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Hip resurfacing- Initial considerations Longevity of any primary THA
cannot be predicted Revision remains an issue
Young/active patient may outlive primary THA.
Hip resurfacing extends continuum of care in young patients with hip disease
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History of Hip resurfacing
1 st generation - Smith Peterson Mould
arthroplasty- numerous failures due to poor material
2nd generation- 60- 70’s Cemented
Metal on poly- Tharies- increased poly debris- HR abandoned almost entirely by 80’s
3rd generation 90’s - metal on metal hybrid arthroplasty Wright medical hip
Amstutz first Hip resurfacing – 1996.
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Candidates for hip resurfacing Young & active patients with hip arthritis
or secondary osteo-arthritis avascular necrosis ankylosing spondylitis post traumatic arthritis DDH Slipped capital femoral epiphysis Primary OA in young patients
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Surgical techniqueFemoral reaming
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Technique- Femoral head cemented in
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Acetabular reaming & component insertion
Uncemented cup Fixationby
circumferential fins (Durom)
Hydoxy apatite coating
Cobalt chrome molybdenum
High carbon content
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Post op x ray Proper position of
femoral component
Proper inclination of acetabular component
Proper depth of acetabular cup
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