The hip resurfacing handbook: A practical guide for the use and management of modern hip resurfacings (for medical professionals)

Edited by K De Smet, ANCA Clinic, Belgium, P Campbell, UCLA, USA and C Van Der Straeten, Consultant, Belgium

Woodhead Publishing Series in Biomaterials No. 47

Hip resurfacing arthroplasty (HRA) using metal-on-metal bearings is an established but specialized technique in joint surgery. Based on the experience of leading experts in the field,The hip resurfacing handbook provides a comprehensive reference on all aspects of this important procedure.

The first part of the book reviews and compares all the major hip resurfacing prostheses, their key design features, relevant surgical techniques and clinical results. Part two discusses clinical follow-up of the hip resurfacing patient, including pre- and post-operative examination, acoustic phenomena and rehabilitation. It also covers the use of techniques such as radiography and metal ion measurement, as well as bone scans, ultrasound, CT, MRI, PET and DEXA, to evaluate hip resurfacings. Part three reviews best practice in surgical technique, including the modified posterior and anterior approaches, as well as instrumentation, anaesthesia and revision surgery. Based on extensive retrieval studies, Part four includes examples of the main failure modes. The final part of the book includes patients’ own experiences, a comparison of HRA with total hip arthroplasty (THA), regulatory issues and relevant web sites.

Comprehensive in its scope and authoritative in its coverage, The hip resurfacing handbook will be a standard work for orthopaedic surgeons and all those involved in HRA.

ISBN 1 84569 948 3
ISBN-13: 978 1 84569 948 2
November 2012
624 pages 279 x 216mm hardback
Approx. £215.00 / US$365.00 / €260.00

PROSPECT

BUY

About the editors

Koen De Smet is one of the world’s leading hip surgeons, having performed more than 3500 hip resurfacings. His annual Advanced Hip Resurfacing Course is widely regarded as a key source of best practice for HRA.

Pat Campbell is Director of the Implant Retrieval Laboratory and Associate Professor in the Department of Orthopaedic Surgery at The University of California Los Angeles (UCLA). She is a leading expert on implant retrieval and analysis.

Catherine Van Der Straeten is a Rheumatologist and an Independent Consultant in Clinical Research with extensive experience in designing and performing hip resurfacing follow-up studies, including ion level monitoring.

PART 1 HIP RESURFACING DESIGNS
PART 2 CLINICAL FOLLOW-UP
PART 3 OPERATIVE TECHNIQUE
PART 4 FAILURE MODES IN HIP RESURFACING
PART 5 GENERAL ISSUES

PART 1 HIP RESURFACING DESIGNS

The ACCIS hip resurfacing prosthesis
K J Hamelynck and R G Woering
- Introduction - Design rationale
- Surgical technique
- Clinical results
- Summary
- References

The ADEPT® hip resurfacing prosthesis
M Tuke
- Introduction
- Design rationale
- Surgical technique
- Clinical results
- References

The DePuy Articular Surface Replacement (ASR) hip resurfacing prosthesis
K De Smet
- Introduction - Design rationale
- Surgical technique
- Clinical results
- Summary
- References

The Birmingham Hip Resurfacing (BHR) prosthesis
P Campbell and K De Smet
- Introduction - Design rationale
- Surgical technique
- Clinical results
- References

The Conserve® Plus hip resurfacing prosthesis
H C Amstutz
- Introduction - Design rationale
- Surgical technique
- Clinical results
- References

The CormetTM hip resurfacing prosthesis
M Norton
- Introduction - Design rationale
- Surgical technique
- Clinical results
- References

The Durom hip resurfacing prosthesis
P Campbell and J Girard
- Introduction - Design rationale
- Surgical technique
- Clinical results
- References

The ESKA hip resurfacing prosthesis
C Van Der Straeten
- Introduction - Design rationale
- Surgical technique
- Clinical results
- References

The ICON hip resurfacing prosthesis
C Van Der Straeten
- Introduction - Design rationale
- Surgical technique
- Clinical results
- References

The MRS Modular Hip Resurfacing prosthesis
C Van Der Straeten
- Introduction - Design rationale
- Clinical results
- References

The MIHR International® hip resurfacing prosthesis
G Singh and S Palmer
- Introduction - Design rationale
- Surgical technique
- Clinical results

The MITCH hip resurfacing prosthesis
D Young and J Burke
- Introduction
- Design rationale
- Clinical results
- Acknowledgements

The BIOMET RECAP hip resurfacing prosthesis
H P Delport
- Introduction - Design rationale
- Surgical technique
- Clinical results
- References

The ROMAX® hip resurfacing system
S Giannini, F Laude, M Menge, H Sadri and F Siccardi
- Introduction - Design rationale
- Surgical technique
- References

The Tornier DynaMoM hip resurfacing prosthesis
J Girard
- Introduction
- Design rationale
- Surgical technique

Design issues and comparison of hip resurfacing prostheses
K De Smet and C Van Der Straeten
- Introduction
- General issues: component identification and metallurgy
- Component sizes
- The acetabular cup design
- The femoral head design
- Comparing hip resurfacing designs
- References

PART 2 CLINICAL FOLLOW-UP

Clinical follow-up of the hip resurfacing patient
K De Smet
- Introduction
- Pre-operative examination
- Post-operative examination
- Treatment options for symptomatic hip resurfacing patients
- References

Acoustic phenomena in hip resurfacing
W L Walter, C Esposito, K De Smet and C Van Der Straeten
- Introduction: the incidence of noise in hip resurfacing
- Acoustic phenomena in resurfacings at the Specialist Orthopaedics Group, Sydney, Australia
- Acoustic phenomena in resurfacings at the ANCA Clinic, Ghent, Belgium
- References

Rehabilitation of patients after hip resurfacing
E Van Haecke and K De Smet
- Introduction
- Post-operative physical therapy whilst in hospital
- Physical therapy after discharge from hospital
- Milestones in rehabilitation
- Patient activities after hip resurfacing

The use of radiography to evaluate hip resurfacing
K De Smet, G Grammatopoulos and A Calistri
- Introduction
- Indications/contra-indications for resurfacing: osteopenia, osteoporosis, osteoarthritis and osteophytes
- Assessing femoral abnormalities
- Assessing acetabular abnormalities
- Assessing other abnormalities
- Using radiographs in pre-operative templating
- Using radiographs to analyse hip implants
- Evaluation of the acetabular cup
- Evaluation of the femoral component
- Assessing hip resurfacing pathology from x-ray analysis
- Conclusions
- References

The use of bone scintigraphy to evaluate hip resurfacing
K De Smet, A Calistri, D Wulfrank and A Blairon
- Introduction
- Bone scans in the normal hip joint
- Bone scans in hip disease
- Bone scans in total hip arthroplasty
- Bone scans in resurfacing hip arthroplasty (RHA)
- Bone scans in adverse tissue reactions
- Conclusion
- References

The use of ultrasound to evaluate hip resurfacing
S Ostlere and J Hauptfleisch
- Introduction
- Advantages and disadvantages of ultrasound
- The role of ultrasound in assessing the painful hip resurfacing
- Ultrasound techniques
- Detection of reactive mass
- Detection of other pathologies
- Case study
- References

The use of Computerized Tomography (CT) to evaluate hip resurfacing
M F Boomsma, H B Ettema and C Van Der Straeten
- Introduction: the science of Computerized Tomography (CT)
- The use of CT scans for preoperative evaluation and planning of hip resurfacing
- The use of CT scans to evaluate hip resurfacings
- Case studies
- Conclusions
- References

The use of magnetic resonance imaging (MRI) to evaluate hip resurfacing
C Van Der Straeten
- Introduction: the science of magnetic resonance imaging (MRI)
- Distinguishing normal and pathological structures
- MRI evaluation of bone
- MRI evaluation of soft tissues
- Case studies
- Conclusions
- References

The use of Positron Emission Tomography (PET) to evaluate hip resurfacing
C Van Der Straeten and J Girard
- Introduction: the basic science of Positron Emission Tomography (PET)
- The use of PET scans to evaluate hip resurfacingic components
- Case studies
- Conclusions
- References

The use of dual energy x-ray absorptiometry (DEXA) to evaluate hip resurfacing
P Campbell and C Van Der Straeten
- Introduction
- Analysing bone using DEXA
- Clinical application of DEXA in hip resurfacing
- Using DEXA to monitor post-operative changes in bone density
- The role of bone mineral density (BMD) in osteonecrosis of the femoral head
- References

The use of metal ion level measurements to evaluate hip resurfacing
R Gill, P Campbell and K De Smet
- Introduction
- Wear particles from the use of cobalt-chrome alloys in hip resurfacing
- Methodological issues in measuring metal ion concentration
- Metal ion levels after metal-on-metal (MoM) hip replacement
- Factors affecting metal ion levels
- Conclusions: the diagnostic use of metal in measurement
- References

The practical application of metal ion level measurement in evaluating hip resurfacing
K De Smet and C Van Der Straeten
- Introduction
- Analytical methodology
- Collection techniques
- Excluding other sources of metal ions
- Metal ion concentration units, conversion factors and statistical analysis
- Safe metal ion limits for unilateral and bilateral metal-on-metal (MoM) hip resurfacing
- The evolution of metal ion levels during run-in and steady-state wear in hip resurfacing
- Metal ion levels with different hip resurfacing designs
- The influence of patient activity on metal ion levels
- Toxicity of metal ions
- Case studies
- Conclusions
- References

PART 3 OPERATIVE TECHNIQUE

Comparing surgical techniques in hip resurfacing
K De Smet and C Van Der Straeten
- Introduction
- Comparing posterior, modified lateral, trochanteric and anterior approaches
- References

Surgical technique in hip resurfacing: the modified posterior approach
K De Smet
- Introduction
- Patient positioning
- Surgical exposure
- Femoral sizing
- Acetabular procedure
- Femoral preparation
- Implantation and closure

Surgical technique in hip resurfacing: the anterior approach
P Beaulé
- Introduction
- Patient positioning and surgical exposure
- Femoral preparation
- Acetabular procedure
- Post-operative recovery

Tips and tricks for successful hip resurfacing
K De Smet
- Introduction: general issues
- Bilateral surgery
- Patient positioning
- Exposure
- Preserving soft tissue
- Acetabular procedure
- Femoral procedure
- Resurfacing in hip dysplasia

Surgical instruments in hip resurfacing
K De Smet
- Introduction
- Acetabular instruments
- Femoral instruments
- Instruments and tools for cementing
- Femoral head impactor
- Summary: an ideal instrument system

Anaesthesia in hip resurfacing
K De Graeve and K De Smet
- Introduction
- General issues
- Unilateral resurfacing
- Bilateral resurfacing
- Revision of a hip resurfacing
- Complications
- Practical application of anaesthesia protocols: the authors’ experience
- Postoperative pain management
- References

Revision surgery for failed hip resurfacing
K De Smet
- Introduction
- Remedial surgery without implant revision
- How to diagnose a failed hip resurfacing
- Reasons for revision of a hip resurfacing
- Options in revision surgery
- Surgical techniques in revision surgery
- Complications in revision of hip resurfacing
- Summary: decision tree for hip resurfacing follow-up and revision: K De Smet and C Van Der Straeten
- References

PART 4 FAILURE MODES IN HIP RESURFACING

Retrieval studies showing failure modes in hip resurfacing
P Campbell
- Introduction: the importance of retrieval studies
- Implant retrieval methods
- Wear measurement
- Femoral sectioning and bone analyses
- Failure modes shown by retrieval studies
- Examples of well functioning hip resurfacings
- References

Case studies of femoral neck fractures in hip resurfacing
P Campbell and K De Smet
- Introduction
- Femoral neck fractures case study 1
- Femoral neck fractures case study 2
- Femoral neck fractures case study 3
- Femoral neck fractures case study 4
- Femoral neck fractures case study 5
- Femoral neck fractures case study 6

Case studies of femoral loosening and femoral head collapse in hip resurfacing
P Campbell and K De Smet
- Introduction
- Femoral loosening/head collapse case study 1
- Femoral loosening/head collapse case study 2
- Femoral loosening/head collapse case study 3
- Femoral loosening/head collapse case study 4
- Femoral loosening/head collapse case study 5
- References

Case studies of acetabular loosening in hip resurfacing
P Campbell and K De Smet
- Introduction
- Surface coatings for acetabular fixation
- Acetabular loosening: case study 1
- Acetabular loosening: case study 2
- Acetabular loosening: case study 3
- Acetabular loosening: case study 4
- References

Case studies of acetabular malposition and high wear in hip resurfacing
P Campbell and K De Smet
- Introduction
- Acetabular malposition/high wear: case study 1
- Acetabular malposition/high wear: case study 2
- Acetabular malposition/high wear: case study 3
- References

Case studies of suspected metal allergy in hip resurfacing
P Campbell and K De Smet
- Introduction
- Aseptic lymphocyte-dominated vasculitis-associated lesion (ALVAL)
- Suspected metal allergy: case study 1
- Suspected metal allergy: case study 2
- Suspected metal allergy: case study 3
- References

PART 5 GENERAL ISSUES

The patient experience of hip resurfacing
K De Smet, P Bolaffio, J Buch, Patient X, P Gabriel and D Dixon
- Introduction
- Patient testimonial: combined revision of a malpositioned hip resurfacing and a primary hip resurfacing (Paolo Bolaffio)
- Patient testimonial: hip resurfacing and the experience of infection (John Buch)
- Patient testimonial: the experience of metal allergy (Patient X)
- Patient testimonial: bilateral hip resurfacing (Peggy Gabriel)
- Patient testimonial: bilateral hip resurfacing (Dru Dixon)

Comparing hip resurfacing arthroplasty (HRA) and total hip arthroplasty (THA)
C Van Der Straeten and K De Smet
- Introduction
- Biomechanical differences between HRA and THA
- Clinical studies comparing HRA and THA
- Comparing outcomes of HRA and THA: complications and revisions
- Comparing survivorship
- Assessing HRA: the consensus of the and Advanced Resurfacing Courses in Ghent
- Conclusions
- References

The current regulatory status of hip resurfacing arthroplasty (HRA)
P Campbell and C Van Der Straeten
- Introduction
- US Food and Drug Administration (FDA) classification and regulation of metal on metal (MoM) hip prostheses
- European Union regulation of metal on metal (MoM) hip prostheses
- References

Web sites relating to hip resurfacing
C Van Der Straeten and P Campbell
- Introduction
- Websites