The Hip Resurfacing Handbook

Koen De Smet is one of the world’s leading hip surgeons, having performed more than 3500 hip resurfacings. His annual Advanced Hip Resurfacing Course is widely regarded as a key source of best practice for HRA. Pat Campbell is Director of the Implant Retrieval Laboratory and a Professor in the Department of Orthopaedic Surgery at The University of California Los Angeles (UCLA). She is a leading expert on implant retrieval and analysis. Catherine Van Der Straeten is a Rheumatologist and an Independent Consultant in Clinical Research with extensive experience in designing and performing hip resurfacing follow-up studies, including ion level monitoring.

"For the orthopaedic surgeon who wishes to consider undertaking hip resurfacing as part of a clinical workload, they would definitely benefit from the wealth of experience and the comparative data from the large range of designs available described in this book." --R J Minns PhD, SCOPE, IPEM

• DedicationContributor contact detailsWoodhead Publishing Series in BiomaterialsAcknowledgementsPrefaceIntroductionPart I: Hip resurfacing designsChapter 1: The advanced ceramic coated implant systems (ACCIS) hip resurfacing prosthesisAbstract:1.1 Introduction1.2 Information about the Advanced Ceramic Coated Implant Systems (ACCIS) Prostheses1.3 Recommended Advanced Ceramic Coated Implant Systems (ACCIS) Surgical Technique1.4 Metal Ion Measurements in Patients after Advanced Ceramic Coated Implant Systems (ACCIS) Hip Arthroplasty1.5 Conclusion1.6 Sources of Further Information and AdviceChapter 2: The ADEPT® hip resurfacing prosthesisAbstract:2.1 Introduction2.2 Design Rationale2.3 Surgical Technique2.4 Clinical ResultsChapter 3: The DePuy Articular Surface Replacement (ASRâ„¢) hip resurfacing prosthesisAbstract:3.1 Introduction3.2 Design Rationale3.3 Instrumentation3.4 Clinical Results3.5 SummaryChapter 4: The Birmingham Hip Resurfacing (BHR) prosthesisAbstract:4.1 Introduction4.2 Design Rationale4.3 Surgical Technique4.4 Clinical ResultsChapter 5: The Conserve® Plus hip resurfacing prosthesisAbstract:5.1 Introduction5.2 Design Rationale5.3 Surgical Technique5.4 Long-Term ResultsChapter 6: The Cormetâ„¢ hip resurfacing prosthesisAbstract:6.1 Introduction6.2 Design Rationale6.3 Surgical Technique6.4 Clinical ResultsChapter 7: The Durom hip resurfacing prosthesisAbstract:7.1 Introduction7.2 Design Rationale7.3 Surgical Technique7.4 Clinical Results7.5 Sources of Further Information and AdviceChapter 8: The ESKA hip resurfacing prosthesisAbstract:8.1 Introduction8.2 Design Rationale8.3 Surgical Technique8.4 Clinical ResultsChapter 9: The ICON hip resurfacing prosthesisAbstract:9.1 Introduction9.2 Design Rationale9.3 Surgical Technique9.4 Clinical ResultsChapter 10: The modular hip resurfacing system (MRS) prosthesisAbstract:10.1 Introduction10.2 Design Rationale10.3 Clinical ResultsChapter 11: The MIHR International® hip resurfacing prosthesisAbstract:11.1 Introduction11.2 Design Rationale11.3 Surgical Technique11.4 Clinical ResultsChapter 12: The MITCH hip resurfacing prosthesisAbstract:12.1 Introduction12.2 Design Rationale12.3 Clinical Results12.4 AcknowledgementsChapter 13: The BIOMET ReCap hip resurfacing prosthesisAbstract:13.1 Introduction13.2 Design Rationale13.3 Surgical Technique13.4 Clinical ResultsChapter 14: The ROMAX® hip resurfacing prosthesisAbstract:14.1 Introduction14.2 Design Rationale14.3 Surgical Technique14.4 Clinical ResultsChapter 15: The Tornier DynaMoM hip resurfacing prosthesisAbstract:15.1 Introduction15.2 Design Rationale15.3 Surgical TechniqueChapter 16: Design issues and comparison of hip resurfacing prosthesesAbstract:16.1 Introduction16.2 General Issues: Component Identification and Metallurgy16.3 Component Sizes16.4 The Acetabular Cup Design16.5 The Femoral Head Design16.6 Comparing Hip Resurfacing DesignsPart II: Clinical follow-upChapter 17: Clinical follow-up of the hip resurfacing patientAbstract:17.1 Introduction17.2 Pre-Operative Examination17.3 Post-Operative Examination17.4 Treatment Options for Symptomatic Hip Resurfacing PatientsChapter 18: Acoustic phenomena in hip resurfacingAbstract:18.1 Introduction: the Incidence of Noise in Hip Resurfacing18.2 Acoustic Phenomena in Resurfacings at the Specialist Orthopaedics Group, Sydney, Australia18.3 Acoustic Phenomena in Resurfacings at the Anca Clinic, Ghent, BelgiumChapter 19: Rehabilitation of patients after hip resurfacingAbstract:19.1 Introduction19.2 Post-Operative Physical Therapy Whilst in Hospital19.3 Physical Therapy After Discharge from the Hospital19.4 Milestones in Rehabilitation19n5 Patient Activities after Hip ResurfacingChapter 20: The use of radiography to evaluate hip resurfacingAbstract:20.1 Introduction: Indications for Resurfacing20.2 Indications/Contra-Indications for Resurfacing: Osteopenia, Osteoporosis, Osteoarthritis and Osteophytes20.3 Assessing Femoral Abnormalities20.4 Assessing Acetabular Abnormalities20.5 Assessing Other Abnormalities20.6 Using Radiographs in Pre-Operative Templating20.7 Using Radiographs to Analyse Hip Implants20.8 Evaluation of the Acetabular Cup20.9 Evaluation of the Femoral Oomponent20.10 Assessing Hip Resurfacing Pathology from X-Ray Analysis20.11 ConclusionsChapter 21: The use of bone scintigraphy to evaluate hip resurfacingAbstract:21.1 Introduction21.2 Bone Scans in the Normal Hip Joint21.3 Bone Scans in Hip Disease21.4 Bone Scans in Total Hip Arthroplasty (THA)21.5 Bone Scans in Resurfacing Hip Arthroplasty (RHA)21.6 Bone Scans in Adverse Tissue Reactions21.7 ConclusionChapter 22: The use of ultrasound (US) to evaluate hip resurfacing (HR)Abstract:22.1 Introduction22.2 Advantages and Disadvantages of Ultrasound (US)22.3 The Role of Ultrasound (US) in Assessing Painful Hip Resurfacing (HR)22.4 Ultrasound (US) Techniques22.5 Detection of Reactive Mass (‘Pseudotumour’)22.6 Detection of other Pathologies22.7 Case StudyChapter 23: The use of computerized tomography (CT) to evaluate hip resurfacingAbstract:23.1 Introduction: The Science of Computerized Tomography (CT)23.2 The use of Computerized Tomography (CT) Scans for Pre-Operative Evaluation and Planning of Hip Resurfacing23.3 The use of Computerized Tomography (CT) Scans to Evaluate Hip Resurfacings23.4 Case Studies From the Isala Clinic, Zwolle, the Netherlands23.5 ConclusionsChapter 24: The use of magnetic resonance imaging (MRI) to evaluate hip resurfacingAbstract:24.1 Introduction: The Science of Magnetic Resonance Imaging (MRI)24.2 Distinguishing Normal and Pathological Structures24.3 Magnetic Resonance Imaging (MRI) Evaluation of Bone24.4 Magnetic Resonance Imaging (MRI) Evaluation of Soft Tissues24.5 Case Studies24.6 Conclusions24.7 AcknowledgementChapter 25: The use of positron emission tomography (PET) to evaluate hip resurfacingAbstract:25.4 ConclusionChapter 26: The use of dual energy X-ray absorptiometry (DEXA) to evaluate hip resurfacingAbstract:26.1 Introduction26.2 Analyzing Bone Using Dual Energy X-Ray Absorptiometry (DEXA)26.3 The Clinical Application of Dual Energy X-Ray Absorptiometry (DEXA) in Hip Resurfacing26.4 Using Dual Energy X-Ray Absorptiometry (DEXA) to Monitor Post-Operative Changes in Bone Density26.5 Bone Mineral Density (BMD) in Osteonecrosis of the Femoral HeadChapter 27: The use of metal ion level measurements to evaluate hip resurfacingAbstract:27.1 Introduction27.2 Wear Particles from the use of Cobalt-Chrome Alloys in Hip Resurfacing27.3 Methodological Issues in Measuring Metal Ion Concentration27.4 Metal Ion Levels After Metal-On-Metal (MOM) Hip Replacement27.5 Factors Affecting Metal Ion Levels27.6 Conclusion: The Diagnostic Use of Metal Ion MeasurementChapter 28: The practical application of metal ion level measurement in evaluating hip resurfacingAbstract:28.1 Introduction28.2 Protocol for Metal Ion Measurement28.3 Metal Ion Concentration Units, Sample Sources and Conversion Factors28.4 Interpretation of Metal Ion Levels: Normal Cobalt and Chromium Levels and Safe Upper Limits for Unilateral and Bilateral Metal-on-Metal (MOM) Hip Resurfacing Arthroplasties28.5 The Evolution of Metal Ion Levels During Run-in and Steady-State Wear in Hip Resurfacing28.6 Metal Ion Levels with Different Hip Resurfacing Designs28.7 The Influence of Patient Activity on Metal Ion Levels28.8 Toxicity of Metal Ions28.9 Case Studies28.10 ConclusionPart III: Operating techniquesChapter 29: Comparing surgical techniques in hip resurfacingAbstract:29.1 Introduction29.2 Comparing Posterior, Modified Lateral, Trochanteric and Anterior ApproachesChapter 30: Surgical technique in hip resurfacing: the modified posterior approachAbstract:30.1 Introduction30.2 Patient Positioning30.3 Surgical Exposure30.4 Femoral Sizing30.5 Acetabular Procedure30.6 Femoral Preparation30.7 Implantation and ClosureChapter 31: Surgical technique in hip resurfacing: the anterior approachAbstract:31.1 Introduction: Rationale for the Anterior Approach31.2 Patient Positioning and Surgical Exposure31.3 Femoral Head Preparation31.4 Acetabular Component Preparation31.5 Post-Operative Recovery31.6 Clinical Experience with the Anterior ApproachChapter 32: Tips and tricks for successful hip resurfacingAbstract:32.1 Introduction: General Issues32.2 Bilateral Surgery32.3 Patient Positioning32.4 Exposure32.5 Preserving Soft Tissue32.6 Acetabular Procedure32.7 Femoral Procedure32.8 Resurfacing in Hip DysplasiaChapter 33: Surgical instruments in hip resurfacingAbstract:33.1 Introduction33.2 Acetabular Instruments33.3 Femoral Instruments33.4 Instruments and Tools for Cementing33.5 Femoral Head Impactor33.6 Summary: An Ideal Instrument SystemChapter 34: Anaesthesia in hip resurfacingAbstract:34.1 Introduction34.2 General issues34.3 Unilateral resurfacing34.4 Bilateral resurfacing34.5 Revision Of a hip resurfacing34.6 Complications34.7 Treatments To reduce blood loss34.8 Practical application Of anaesthesia protocols: the authors' experience34.9 Post-operative pain managementChapter 35: Revision surgery for failed hip resurfacingAbstract:35.1 Introduction35.2 Remedial Surgery without Implant Revision35.3 How to Diagnose a Failed HIP Resurfacing35.4 Reasons for Revision of a HIP Resurfacing35.5 Options in Revision Surgery35.6 Surgical Techniques in Revision Surgery35.7 Complications in Revision of HIP Resurfacing35.8 Summary: Decision Tree for HIP Resurfacing Follow-up and RevisionPart IV: Failure modes in hip resurfacingChapter 36: Implant retrieval studies showing failure modes in hip resurfacingAbstract:36.1 Introduction: the importance Of retrieval studies36.2 Implant retrieval methods36.3 Wear measurement36.4 Femoral sectioning For cement And bone analyses36.5 Failure modes shown by retrieval studies36.6 Examples Of well-functioning hip resurfacingsChapter 37: Case studies of femoral neck fractures in hip resurfacingAbstract:37.1 Introduction37.2 Femoral neck fractures: CASE 137.3 Femoral neck fractures: CASE 237.4 Femoral neck fractures: CASE 337.5 Femoral neck fractures: CAsE 437.6 Femoral neck fractures: CAsE 537.7 Femoral neck fractures: CASE 6Chapter 38: Case studies of femoral loosening and femoral head collapse in hip resurfacingAbstract:38.1 Introduction38.2 Femoral Loosening/Head Collapse: Case 138.3 Femoral Loosening/Head Collapse: Case 238.4 Femoral Loosening/Head Collapse: Case 338.5 Femoral Loosening/Head Collapse: Case 438.6 Femoral Loosening/Head Collapse: Case 5Chapter 39: Case studies of acetabular loosening in hip resurfacingAbstract:39.1 Introduction39.2 Surface Coatings for Acetabular Fixation39.3 Acetabular Loosening: CASE 139.4 Acetabular Loosening: CASE 239.5 Acetabular Loosening: CASE 339.6 Acetabular Loosening: CASE 4Chapter 40: Case studies of acetabular malposition and high wear in hip resurfacingAbstract:40.1 Introduction40.2 Acetabular Malposition/High Wear: CASE 140.3 Acetabular Malposition/High Wear: CASE 240.4 Acetabular Malposition/High Wear: CASE 340.5 Acetabular Malposition/High Wear: CASE 440.6 Acetabular Malposition/High Wear: CASE 5Chapter 41: Case studies of suspected metal allergy in hip resurfacingAbstract:41.1 Introduction41.2 Aseptic Lymphocyte-Dominated Vasculitis-Associated Lesion (ALVAL)41.3 Suspected Metal Allergy: CASE 141.4 Suspected Metal Allergy: CASE 241.5 Suspected Metal Allergy: CASE 3Part V: General hip resurfacing issuesChapter 42: The patient experience of hip resurfacingAbstract:42.1 Introduction42.2 Patient Testimonial: Combined Revision of a Malpositioned Hip Resurfacing and a Primary Hip Resurfacing (Paolo Bolaffio)42.3 Patient Testimonial: Hip Resurfacing and the Experience of Infection (John Buch)42.4 Patient Testimonial: The Experience of Metal Allergy (Patient X)42.5 Patient Testimonial: Bilateral Hip Resurfacing (Peggy Gabriel)42.6 Patient Testimonial: Bilateral Hip Resurfacing (Dru Dixon)Chapter 43: Comparing hip resurfacing arthroplasty (HRA) and total hip arthroplasty (THA)Abstract:43.1 Introduction43.2 Biomechanical Differences Between Hip Resurfacing Arthroplasty (HRA) and Total Hip Arthroplasty (THA)43.3 Clinical Studies Comparing Hip Resurfacing Arthroplasty (HRA) and Total Hip Arthroplasty (THA)43.4 Comparing Outcomes of Hip Resurfacing Arthroplasty (HRA) and Total Hip Arthroplasty (THA): Complications and Revisions43.5 Comparing Survivorship43.6 Assessing Hip Resurfacing Arthroplasty (HRA): The Consensus of the 2009 and 2010 Advanced Resurfacing Courses in Ghent43.7 ConclusionChapter 44: The current regulatory status of hip resurfacing arthroplasty (HRA)Abstract:44.1 Introduction: US Food and Drug Administration (FDA) Classification and Regulation of Metal-on-Metal (MOM) Hips44.2 European Union Regulations for Metal-on-Metal (MOM) Hips44.3 Regulatory Status TableChapter 45: Websites relating to hip resurfacingAbstract:Index