Artificial Hip Replacement

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Artificial Hip Replacement

• John Donahoe

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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.

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Components

• Acetabular Cup
• Femoral Component
• Articular Interface
• Hemiarthroplasty
• Femoral Head
• Total Hip Arthroplasty

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Reasons for Arthroplasty

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

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Materials

• 4 Common types
• Metal-Metal
• Metal-Plastic (longest used)

• -Ceramic-Plastic
• Ceramic-Ceramic

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Materials (Cont.)

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

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Positives Negatives

• Ceramic
• 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

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Approaches

• Posterior
• Lateral
• Antero-lateral
• Minimally Invasive
• Smaller incisions, less scarring, limits vision,
  may require special x-ray equipment

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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)

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Health Risks

• Infection
• Blood Clots
• Leg-Length Inequality
• Dislocation
• Corrosion
• Metallosis (Metal)
• Osteolysis (Plastic or Metal)
• Pseudotumors
• Necrosis

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Recalls

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

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Moving Forward

• Alternate Materials
• Ivory
• Dr. San Baw (300 procedures from 1960-1980, 88
  success, all ages 24-87, physical activity)
• Carbon Fiber?
• Ceramic development

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Sources

• http//bonesmart.org/hip/hip-replacement-implant-m
  aterials/
• http//en.wikipedia.org/wiki/Hip_replacementMetal
  -on-metal_hip_implant_failure
• http//www.sullolaw.com/productdefects/hip-metallo
  sis.aspx?kid97C4CB9C-64C8-48B5-8A09-08305B53E9B1
  ad24761454863kw2Bmetallosissourceadwordscam
  paignTop-Metallosis-KeywordsgclidCKHe-6Ts0LkCFV
  Oe4AodXFoADQ
• http//www.stryker.co.uk/index/st_pag_patients-hom
  e/st_pag_patients-hip/st_pag_patients-hip-replacem
  ent.htm
• http//www.minfirm.com/nj-pa-depuy-recall-attorney
  s-defective-replacements-signs-symptoms
• http//orthoinfo.aaos.org/topic.cfm?topica00377
• http//www.rightdiagnosis.com/h/hip_replacement/st
  ats.htm