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Re: m/m revisions

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Good question. To me, at least, the answer revolves around the cause of the

failure. If the femoral portion fails because of loosening, for example,

could not it be replaced without replacing the acetabular portion.

Likewise, if the acetabular portion loosens, its removal might not be all

that difficult. Has anyone had revision of a resurfacing and, if so, how

was it done?

> m/m revisions

>

> I have been wondering about whether or not an intact acetabular cup (in a

> Conserve Plus) could be used if a THR needed to be performed, i.e. could

> the

> cup be saved and coordinated w/a conventional femoral stem. I asked an

> orthopedic surgeon this question & he said this could not work in his

> view;

> in the event that a resurfacing would fail, all components would need to

> be

> changed. He also said that to remove an acetabular cup that is well-fixed

> would require bone loss that would not be inconsequential.

>

> In conversation w/JRI earlier this year, it was mentioned that a " jumbo

> ball " was being considered. Does anyone out there have any thoughts on

> all

> this?

>

>

>

>

>

>

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In a message dated 12/12/00 5:27:03 PM Eastern Standard Time,

catexd@... writes:

<< I have been wondering about whether or not an intact acetabular cup (in a

Conserve Plus) could be used if a THR needed to be performed, i.e. could the

cup be saved and coordinated w/a conventional femoral stem. I asked an

orthopedic surgeon this question & he said this could not work in his view;

in the event that a resurfacing would fail, all components would need to be

changed. He also said that to remove an acetabular cup that is well-fixed

would require bone loss that would not be inconsequential.

In conversation w/JRI earlier this year, it was mentioned that a " jumbo

ball " was being considered. Does anyone out there have any thoughts on all

this?

>>

Dr.'s Mont and Gross both have mentioned that they would replace the femoral

part of the Conserve with a thr with a larger ball . I have written before

that to remove the cup would cause damage and loss of bone. As I think about

this larger ball concept first I would say that we don't have any do we???

Secondly, would it not be preferable that the larger ball, if we had one was

made by WMT and not some other manufacturer. Takes me back to the old

McKee-Farrar bearings that are so infamous.

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>Takes me back to the old

> McKee-Farrar bearings that are so infamous.

,

What's infamous about the McKee-Farrar joints? My Dad's pair are

still going strong after 29 years and show no wear at all on X-ray.

If I have to be revised to anything, I'll settle for that!!

Dave

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> In a message dated 12/14/00 3:44:35 PM Eastern Standard Time,

> david.vale@b... writes:

>

> << What's infamous about the McKee-Farrar joints? My Dad's pair are

> still going strong after 29 years and show no wear at all on X-ray.

>

> If I have to be revised to anything, I'll settle for that!!

>

> Dave

>

> >>

> Dave,

>

> I have always been glad for your father as I have expressed in the

past. You

> do know that the bearings in general were a big failure and that

they had

> design and tolerance problems. The point was that it is not a big

enough

> cohort of people who had long term success to draw conclusions

about metal

> debris.

,

No I didn't know that they generally failed. I got the impression

from the MMT site (quoted below)that the 1960's version was highly

successful and that it was only rather iffy lab test results by

Charnley that turned people away from m/m.

" He (McKee) developed various uncemented prototype total hip

replacements in the 1940's and 1950's. McKee presented his

results to the BOA meeting in Cambridge in 1951. The results in those

early days were initial relief of pain followed by loosening and

mechanical failure.

....

McKee's cement fixed McKee-Farrar THR from 1960 was the first

widely used and successful THR. "

In fact, I thought it was the long term success of these and

Ring's design which inspired the current work on m/m resurfacing.

Have you seen any statistics on it?

Regards,

Dave

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