Frequently Asked Questions - All FAQs

CONSERVE PLUS (C+), manufactured by Wright Medical Company (www.wmt.com). 

BHR (Birmingham Hip Resurfacing), which has a metal-on-metal bearing, manufactured by Smith & Nephew Company (MMT Company has been sold in March 2004 to the Smith & Nephew Company www.smith-nephew.com).

 

The poor results of Wagner resurfacing are mainly caused by poor performing bearing couples (metal-on-poly, or ceramic-on-poly). Not by the resurfacing procedure itself. The main problem with young and/or active patients was the wear of polyethylene. Especially in the case of the Wagner prosthesis with a big metal head on a thin polyethylene socket, the wear is increased by a factor 4 to 10.

See frontpage.

I am doing only total resurfacings. Hemi’s (hemiarthroplasty) are not performed in Europe. They are not done because they are not performing as well as full resurfacings. In the USA they are done because the total resurfacing is not yet FDA approved! In young people cartilage will wear out and osteoarthritis symptons will occur.

I am doing only total resurfacings. Hemi’s (hemiarthroplasty) are not performed in Europe. They are not done because they are not performing as well as full resurfacings. In the USA they are done because the total resurfacing is not yet FDA approved! In young people cartilage will wear out and osteoarthritis symptons will occur.

I have performed a few thousands of THA (see front page). I am still doing everything in THR, you have to choose the best prosthesis for every patient. For a patient older than 75 this will be a cemented stem with a metal-on-poly cup! Economically and scientifically the best. For other patients it can be uncemented ceramic-on-ceramic, or metal-on-metal. Until the age of 75 I use ceramic-on-ceramic with the largest possible head diameter (28-32-36 mm) (www.stryker.com).

BHR procedure is developed in 1996/97. The first metal-on-metal resurfacing is from Feb. 1991. The resurfacing is already 40 years old, metal-on-metal is 40 years old (the oldest dates from 1938!). Both ideas were put together by Mr. McMinn in 1989.
The Conserve Plus design was introduced by Dr. Amstutz in 1995.

Oldest BHR is from 1997. My oldest patient is around 75 (male patients with a young wife – very active older male patients still can be suitable for BHR).
Oldest C+ hip dates from the year 1996. As long the bone quality is good, resurfacing can be performed.

I DON’T KNOW! It is only one of the possibilities to do longer than 10 years in young and active people! If you don’t get osteolysis (bone that is going away) or no measurable wear of the friction couple, metal-on-metal resurfacing can last very long. Just give me a crystal bal. There are large metal-on-metal articulations that stayed for more then 30 years. If activity will play a big part in the wear of the prosthesis, is today also questionable.

I DON’T KNOW! It is only one of the possibilities to do longer than 10 years in young and active people! If you don’t get osteolysis (bone that is going away) or no measurable wear of the friction couple, metal-on-metal resurfacing can last very long. Just give me a crystal bal. There are large metal-on-metal articulations that stayed for more then 30 years. If activity will play a big part in the wear of the prosthesis, is today also questionable.