Branded PPT Template

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Russell Meldrum, MD
Indiana, University , School of Medicine,
Department of orthopedics
550 North University Blvd., Room 1250
Indianapolis, IN 46202
317-274-7359
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Overview

• Named for Birmingham, England, where the devices
  creators practice medicine
• Used globally since 1997 More than 65,000
  implanted
• Approved by the FDA in March 2006
• In an international study of 1,626 hips, 99.5
  of patients were Pleased or Extremely
  Pleased with the results of the BIRMINGHAM HIP
  Resurfacing (BHR) System.

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Who is the typical candidate for BHR System?

• Adults under age 60 for whom total hip
  replacement may not be appropriate due to an
  increased level of physical activity
• Active adults over age 60 may be candidates,
  depending on their bone quality

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Anatomy

• Socket
• Ball
• Femoral neck
• Smooth weight-bearing surfaces
• Smooth cartilage
• Femur

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Diseases of the hip
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Osteoarthritis (OA)

• Wear and tear arthritis
• Joint becomes pitted, eroded, unevenand painful
• Bone spurs, or osteophytes, often form
• The common activities of daily living become
  limited by extreme pain

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Hip dysplasia

• Congenital disease that affects 1 in 1,000 people
• The hip doesnt develop the normal wear
  patterns, which leads to early OA
• Chief risk factor family history
• Women, first-born children and breech babies have
  higher rates of dysplasia

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Avascular necrosis (AVN)

• Caused when there is a disruption of the blood
  supply to the hip
• In time, the bone will die and the femoral head
  will collapse
• Leading causes Alcoholism, corticosteroids
• Other risk factors blood vessel blockage due to
  sickle cell anemia or fat particles, or from
  dislocation of the hip due to trauma

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Non-surgical alternatives
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Non-surgical alternatives

• Lifestyle modification
• Exercise and physical therapy
• Anti-inflammatory medication

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Risks
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Risks

• Thromboembolism
• Infection
• Pneumonia

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The procedure
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Conventional hip replacement
Healthy hip
Cuts
Implant components
Implanted
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The BHR System
Healthy hip
Cuts
Implant components
Implanted
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Conventional vs. BHR Resurfacing
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Conventional vs. the BHR System
Total hip cuts
BHR System cuts
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Is it minimally invasive?
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That depends on how you define Minimally
Invasive.

• Soft Tissue
• No. Incision length of 6 to 8 inches
• Bone
• Yes. Preserves your bodys natural bone
  structure It resurfaces rather than replaces

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The implant
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The key benefits

• Head size
• Advanced bearing surface
• Bone conservation

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Head size
Healthy head
BHR head
Total hip head

• Closely matches the size of your natural femoral
  head
• Larger than the head of a total hip replacement
• Larger head means a reduced chance of dislocation
  after surgerya leading cause of revision surgery
• 1-3 of total hips dislocate over the lifetime
  of the implant
• 0.3 of BHR implants dislocated in the first 5
  years after surgery (in a study of 2,385 hips)

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Advanced bearing surface

• Metal-on-metal implant
• No plastic liner like most total hip replacements
• All-metal total hip replacements reduce joint
  wear by 97 versus metal on plastic total hips
  BHR implants were found to be in this range

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Bone conservation
Hip with osteoarthritis
Bone cuts fora traditionalhip replacement
Bone cuts forBHR System

• Preserves your natural femoral neck
• Neck length and angle determine accurate leg
  length
• With the BHR System, you retain your original
  equipment with a total hip, your femoral neck is
  replaced by the implant

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Bone conservation (cont.)

• Revises to a primary
• If you need revision surgery, you dont get a
  revision implant
• The follow-up procedure would be the same total
  hip replacement you would otherwise have received

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After surgery
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After surgery

• You will undergo a rehabilitation protocol
  similar to total hip replacement patients
• During year-one Low-impact activities as your
  bone and muscles adjust to the new stresses
  (swimming, walking, bicycling)
• After year-one Higher impact physical activity
  may be appropriate (singles tennis, jogging)

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