native to total hip replacement

It’s Hip to Resurface

“I chose this procedure because I knew I could remain active and still be in line for a hip replacement when I get older and slow down a bit.”

Stephen Andrews

IIT WAS A RED-LETTER DAY WHEN YOU TIED YOUR SHOELACES FOR THE FIRST TIME. You stood there, beaming with pride when your mom and dad told you what a wonderful job you had done. It was a rite of passage because after all, “only big boys and girls can tie their shoelaces all by themselves.”

For 58-year-old Stephen Andrews, tying his shoelaces was a painful experience. He couldn’t tie them without feeling like someone was stabbing him with a knife.

HHE BEGAN TO WALK WITH A NOTICEABLE LIMP. And as a civil litigation attorney, it was uncomfortable for him to approach the bench or sit for any length of time — both of which made it difficult for him to practice. He couldn’t get a good night’s sleep, which also affected his work, and performing any type of physical activity such as hiking was almost impossible. It was time to take action. After a year of experiencing constant pain in his left hip,

Andrews resigned himself to the fact that he would have to have a total hip replacement. “I was a little apprehensive about a total hip replacement because I thought I would have to give up my active lifestyle and have to start watching my diet more closely,”

Andrews said. “But I knew I had to take some kind of action because the pain was really making my life miserable.” He then met Dr. Kenneth Mathis, chairman of the Department of

Orthopedic Surgery at The Methodist

Hospital, who told him about an alternative to total hip replacement, a new procedure called Birmingham Hip Resurfacing (BHR).

BHR was developed in 1997 in Birmingham, England, as a way to preserve bone and joint stability in young, active people. Tens of thousands of patients have undergone the procedure in Great Britain, Canada, Australia, Japan and throughout Europe. The Food and Drug Administration approved it for use in the United States in 2006.

Hip resurfacing involves placing a metal cap over the ball of the hip joint rather than completely removing the ball, hip socket and diseased parts of the hip joint (total hip replacement), helping a patient retain more bone than a total hip replacement.

The best candidates for BHR are men who are in their 30s, 40s and 50s, although active women in this age group who don’t have early osteoporosis may be candidates as well.

“Men in these age groups who are very active and receive a total hip replacement are more susceptible to damaging or loosening of the implant because of their active lifestyle,” Mathis said. “If the implant loosens or fails, the patient has to undergo revision surgery. Every time you do this you have to place the revision implant deeper into the remaining undamaged bone to obtain solid fixation.”

Hip resurfacing seems to give patients more of an athletic hip as

BIRMINGHAM HIP RESURFACING

BHR implant (left), total hip replacement implant (right).

The BHR System relieves hip pain and improves hip function by replacing the parts of the hip that have been severely damaged by degenerative joint diseases. CUP

The cup replaces the damaged surface of the hip socket. Bone grows into the socket adding increased stability. The cap covers the ballshaped bone at the top of the thigh. The cap has a small stem that is inserted into the top of the thighbone.

well as preserves the bone. Many patients have reported returning to very high activity levels and participating very actively in sports.

During a one hour surgery, the surgeon smooths out the rough surfaces of the hip joint bones and covers them with a more durable high carbide cobalt chrome metal cap.

If the patient needs a total hip replacement later, it will seem like they are undergoing hip surgery for the first time because the femoral shaft bone was not compromised during the hip resurfacing.

“MANY ACTIVE PEOPLE REQUIRE HIP SURGERY BECAUSE OF ARTHRITIS OF THE HIP, a disease that wears away the cartilage between the femoral head and the acetabulum (the cup-shaped cavity at the base of the hipbone), causing the two bones to scrape against each

Dr. Kenneth Mathis

other,” said Dr. David Lionberger, a Methodist orthopedic surgeon.

When this happens, the joint becomes pitted, eroded and uneven, resulting in pain, stiffness and instability. This can severely limit movement in the leg. Oftentimes people first notice pain in their groin area when taking part in weight-bearing exercises or walking.

“To have a procedure that acts as a spacer while sparing more of the native bone is a marvelous step forward in preserving options for the future in this very active group of patients,” Lionberger said.

Andrews had surgery on his left hip March 1, 2007. He said the heavy duty hip pain was gone when he woke up after surgery. He was riding a stationary bike just six weeks later. At four months post-surgery, he was back hiking a little more than nine miles with his family in Acadia National Park in Maine, just like he does every summer. The difference this time is that he did it pain-free.

He says hip resurfacing has changed his life for the better. He’s now able to get a good night’s sleep, he can get in and out of the car without a problem and he can tie his shoelaces.

“I chose this procedure because I knew I could remain active and still be in line for a hip replacement when I get older and slow down a bit,” he said. “I believe it’s one of the best decisions I have ever made.”

THE METHODIST HOSPITAL’S BONE AND JOINT CENTER

is among the largest and most comprehensive orthopedic centers in the United States. From joint replacement and spine surgery to sports medicine and foot/ankle surgery, Methodist physicians treat approximately 5,000 patients and perform more than 10,000 surgeries annually. Methodist is often a referral site of choice for even the most complex cases, attracting patients from across the nation andaround the world.

METHODIST ORTHOPEDIC SUBSPECIALTIES

UPPER EXTREMITY:

SHOULDER, ELBOW UPPER EXTREMITY:

HAND/WRIST SPORTS MEDICINE SPINE LIMB RESTORATION JOINTREPLACEMENT RHEUMATOLOGY LOWER EXTREMITY:

HIP, KNEE, FOOT/ANKLE

For more information or to make an appointment, call 713.790.3333

Leading

Medicine

Heart disease is the leading cause of death in America for both men and women. It doesn’t discriminate against its victims and in spite of our attempts to prevent it; it often finds a way of creeping into our lives. “Leading Medicine,” a 30-minute television special produced by The Methodist Hospital, offers lifesaving information on how to prevent and treat heart disease.

To order your free DVD of this program that aired on KHOU-TV (channel 11), call 713.790.3333.