Artificial Hip Replacement

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Presentation transcript:

Artificial Hip Replacement John Donahoe

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 Articular Interface Femoral Component Hemiarthroplasty Femoral Head Total Hip Arthroplasty

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

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

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

Positives & Negatives Ceramic Metal Plastic 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 vision, may require special x-ray equipment

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 (Metal) Osteolysis (Plastic or Metal) Pseudotumors Necrosis

Recalls DePuy ASR XL DePuy ASR hip resurfacing system Stryker Rejuvenate Stryker ABGII Smith and Nephew R3 Acetabular System

Moving Forward Alternate Materials Ivory Carbon Fiber? 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/hip-replacement-implant-materials/ http://en.wikipedia.org/wiki/Hip_replacement#Metal-on-metal_hip_implant_failure http://www.sullolaw.com/productdefects/hip-metallosis.aspx?kid=97C4CB9C-64C8-48B5-8A09-08305B53E9B1&ad=24761454863&kw=%2Bmetallosis&source=adwords&campaign=Top-Metallosis-Keywords&gclid=CKHe-6Ts0LkCFVOe4AodXFoADQ http://www.stryker.co.uk/index/st_pag_patients-home/st_pag_patients-hip/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=a00377 http://www.rightdiagnosis.com/h/hip_replacement/stats.htm