Metal Bearings: Hip Resurfacing
The Birmingham Hip Resurfacing (BHR), designed by Derrek McMinn, and Conserve Plus (C+) are used in our clinic. These prostheses are conform with the mentioned philosophy concerning young patients.
For development and technical specifications,see www.hipresurfacing.com. Important to mention is the fact that this prostheses containing high-carbides on the metal surface, all necessary to obtain an ideal low wear friction couple! The theoretical advantages of the metal-on-metal articulation are :
- less wear;
- less bone resorption;
- less leg length discrepancy and offset problems;
- an anatomical reconstruction;
- avoiding of “stress-shielding”;
- maximal proprioceptive feedback;
- minimal risk for dislocation;
- revision surgery is easier.
The bad reputation of the resurfacing technique in the past, namely the teflon prosthesis of Charnley and metal- on-polyethylene prosthesis of WagnerWagner or Tharies prosthesis, is based on failure of the design and material properties of the implants, rather than failure of the resurfacing concept.
Due to a perfect operation technique, an up-to-date knowledge and fabrication of metal-on-metal articulations, the Resurfacing technique is doing extremely well with clinical and radiological follow-up for more than 10 years.
Properties of Resurfacing
Indications for Resurfacing
- All indications for THA in:
- Male patients younger than 65;
- Female patients younger than 55-60.
- Head deformities of the femoral head;
- Where restoration of leg length and offset is not possible.
In these cases a modular big ball head can be used with a stemmed femoral prosthesis with the same metal-on-metal properties as a resurfacing, and big ball head advantages. See also “big ball heads”, and “contra-indications”. A ceramic-on-ceramic large ball head (36 mm) is another possibility.