Hip Recalls
Sep,25,2008 08:21
As I’m
sure many of you are aware, there have been a number
of recalls of hip replacements, recently. The Zimmer
Durom cup and the Stryker Trident ceramic system have
both come under suspicion of causing problems. A
number of my patients have been calling with concern
about the hips that they have in place or are
getting. I’ve been very fortunate in that I’ve never
used either of these components. While it’s
impossible to predict the future, I try very hard to
use proven technology that has a long track record.
Patients depend on us, as surgeons, to pick an
implant that works the best for them, but will also
last a long time. I take this issue very seriously
and my philosophy is always to use the best implant
available at any given time. I am always open to
discussion about the actual parts being used. If
something is going to be part of a patient’s body,
they should be very well informed about it
beforehand.
|
Birmingham Update
Jun,10,2008 21:51
We’ve been
using the Birmingham hip resurfacing for about a year
now. I think that overall, it’s been a great success.
The patients are very happy with their quick recovery
and we’ve have very few problems. I believe that the
most important key to success is picking the correct
patients for the surgery. The ideal patients are
younger, active, and have arthritis without a lot of
deformity. It’s also important to examine the bone
for cysts and other problems that might lead to early
failure. For younger patients who don’t fit these
criteria, they do extremely well with metal-on-metal
total hip replacement.
I’m going to be attending a meeting in August that will focus on some future possibilities with resurfacing. Hopefully, I’ll be able to post a new update then.
I’m going to be attending a meeting in August that will focus on some future possibilities with resurfacing. Hopefully, I’ll be able to post a new update then.
Pain Control After Surgery
Apr,15,2008 08:41
Controlling
pain is one of the most important areas of
postoperative care. It is usually the aspect of
surgery that scares patients the most and is most
ignored by doctors. We have tried to take a more
comprehensive approach. The most important principle
is to treat the pain with different modalities so
that we have to use the least amount of narcotics.
Narcotics are the drugs that make patients sleepy,
constipated and unable to cooperate well with their
physical therapy.
We use local blocks, spinal anesthesia and injections around the incision to help control pain. By combining these methods with nonsedating drugs, we are able to keep patients very comfortable and use very little sedation after surgery. The nurses who take care of our patients after surgery have seen a dramatic difference in the amount of pain that patients report to them after surgery. I see this as one of the most important aspects of our care and does more to ensure rapid recovery than any other method we employ. If you have any specific questions about the exact methods we use, please email me any time.
We use local blocks, spinal anesthesia and injections around the incision to help control pain. By combining these methods with nonsedating drugs, we are able to keep patients very comfortable and use very little sedation after surgery. The nurses who take care of our patients after surgery have seen a dramatic difference in the amount of pain that patients report to them after surgery. I see this as one of the most important aspects of our care and does more to ensure rapid recovery than any other method we employ. If you have any specific questions about the exact methods we use, please email me any time.
Tapered Titanium Stems
Mar,15,2008 08:41
We've been
using tapered titanium stems for total hip
replacements for many years now. They fit into the
thigh bone and require no cement. The bone grows into
the roughened surface plasma sprayed onto the
titanium to make the new part literally part of the
natural bone. I recently wrote a short monograph,
along with some other well know physicians, that was
published in one of the orthopaedic trade journals.
If you would like some more information, here is
the
link. My
article is on pages 7-8.
Anterior Hip Replacement
Feb,15,2008 08:42
Our
anterior hip project continues to progress well. We
are able to perform the hip replacement without using
special tables or x-ray machines, which makes it
quicker and easier to set up. There is also less
uncertainty about the placement of the components
when I can see them directly. Patients appear to have
little to no pain, although, I'll have to collect
more data to know for sure. Certainly, they are
recovering their function and ability to walk very
rapidly.
Birmingham Hip Resurfacing
May,15,2007 08:40
We are now
approved to do the Birmingham hip resurfacing at the
Rubin Institute. I've done a lot of very similar
surgery in the past, so this new prosthesis isn't
much of a change. I had to go through training with
the designer, Mr. Derek McMinn, from Birmingham,
England, before we could get the prosthesis at our
hospital. The big difference is that the Birmingham
hip is FDA approved. The other hip resurfacings in
the US are still being investigated and haven't been
approved, mostly due to the lack of good long term
data. We are very excited to have the ability to
offer this option to our younger patients. If you
want some more in depth information on hip
resurfacing, take a look at
SurfaceHippy, an
independent site which had collected a lot of
excellent information on hip resurfacing.