Re: Why American Doctors Cringe - Setting The Record Straight

[Guest guest]

There are severalreasons why American doctors are so resistant to

this concept. The first is the disastrous experience with the

original resurfacings back in the 1970/80s when they used teflon

liners. The hips failed in so many ways and so quickly that the

concept was quickly discarded. At that time the accepted THR device

was the Charnley hip that also had a teflon liner but these hips

seemed to last longer than the resurfacing hips in large part because

of the smaller size of the acetabular head. As a result hip

resurfacing was viewed as an invalid concept. The problem of course

was with the teflon liner not the concept. Nevertheless most most US

surgeons continue to view the resurfacing concept with a great deal

of scepticism.

The second problem is what I call the " not invented here " problem.

Hip resurfacing has been pioneered in the UK. For most American

doctors health care in the UK comes nowhere near the level of

technology and quality of care found in the US. As a result it is

difficult for them to accept the idea that good technolgy can and has

been developed in the UK. If the concept had been pioneered in the

US it would be a different story.

The final reason is the litigious nature of the USA. With rapidly

increasing malpractice insurance costs doctors are well aware of the

risks they face in embracing new " doubtful " technology particularly

technology that has failed in the past. In some ways you can't blame

them.

By the way I am a 3 year veteran of a BHR carried out at Princess

Grace Hospital in London by Muirhead-Allwood. My hip is

perfect and I am functioning normally and have had no post-op

problems. A recent survey of all BHRs carried out by showed

95% of the recipients were functioning at a normal level. is

an extraordinary surgeon and one of the top hip surgeons in the world

(she did the Queen Mother's hip). As a result she is difficult to

get an appointment with but well worth the wait. In 2001 the total

cost was GBP12,000

> > I'm just trying to get the record straight here and am looking

> > for verification or disqualification of this statement. I believe

> > that the reason why American Doctors are so conservative about

> what

> > they want their patients to do or not do is NOT because they

don't

> > trust the devices but because they want to see the devices get

> > approved so that insurance companies will cover all of us looking

> to

> > get a hip resurface.

> >

> > At least that is the impression that I got with Dr.

> Kennedy

> > and his group down in Sarasota, Florida. They loved the devices

> but

> > want to go easy until this thing is FINALLY approved by the FDA.

> > The P.A. Mark in his office liked to share stories of people

> pushing

> > it past the limit even though he told me to go easy. One guy for

> > example worked on a fishing boat and invited Mark to come see him

> at

> > work and go off-shore fishing for free basically. When Mark

first

> > got there he saw this patient who was 5 months after surgery

slide

> > down the mast of the boat and bounce off a cooler and jump on the

> > deck, smiling all the time and saying " works pretty good, doesn't

> > it? " . He told of another (a foot doctor) who went back to work

> > only 4 weeks after surgery and I went back to work after 4.5

weeks.

> >

> > So once again I think the American doctors may be getting a bum

> rap

> > for trying to look out for our best long term interests which are

> to

> > get these things out there for all patients. Also, we have to

> admit

> > that the lawsuit frenzy in this country has some down sides.

> >

> > Jeff (01-03-03 C2K)

> >

> > P.S. I walked and jogged last night as I tried to imitate normal

> > Americans trying to get back in shape after making a New Years

> > resolution.

[Guest guest]

> > I'm just trying to get the record straight here and am looking

> > for verification or disqualification of this statement. I

believe

> > that the reason why American Doctors are so conservative about

> what

> > they want their patients to do or not do is NOT because they

don't

> > trust the devices but because they want to see the devices get

> > approved so that insurance companies will cover all of us

looking

> to

> > get a hip resurface.

> >

> > At least that is the impression that I got with Dr.

> Kennedy

> > and his group down in Sarasota, Florida. They loved the devices

> but

> > want to go easy until this thing is FINALLY approved by the FDA.

> > The P.A. Mark in his office liked to share stories of people

> pushing

> > it past the limit even though he told me to go easy. One guy

for

> > example worked on a fishing boat and invited Mark to come see

him

> at

> > work and go off-shore fishing for free basically. When Mark

first

> > got there he saw this patient who was 5 months after surgery

slide

> > down the mast of the boat and bounce off a cooler and jump on

the

> > deck, smiling all the time and saying " works pretty good,

doesn't

> > it? " . He told of another (a foot doctor) who went back to work

> > only 4 weeks after surgery and I went back to work after 4.5

weeks.

> >

> > So once again I think the American doctors may be getting a bum

> rap

> > for trying to look out for our best long term interests which

are

> to

> > get these things out there for all patients. Also, we have to

> admit

> > that the lawsuit frenzy in this country has some down sides.

> >

> > Jeff (01-03-03 C2K)

> >

> > P.S. I walked and jogged last night as I tried to imitate normal

> > Americans trying to get back in shape after making a New Years

> > resolution.

I was afraid that I was going to be misunderstood exactly like

it appears that this message was taken. I am strickly talking

about doctors who approve of hip resurfacing and not doctors that

ignore the facts. I too had a very negative experience with our

beloved Jewitt Orthopedic Clinic in Orlando who are suppose to be

the experts and couldn't care less about this procedure. What I

was trying to say was that the American doctors that are doing the

procedure don't encourage their patients to overdoit with exercise

because they are trying to show the best numbers possible and use

longevity information against many OSs who are against this

procedure. Thats all.

We know that the data is there for successful recoveries but there

is no long term data and that is the issue that those against this

procedure continue to hold over our heads. There is less than 10

years of study data despite the fact that the data is wonderful,

excellent, etc. If this was a life and death situation we would

probably get more flexibility with our medical community. I know

that many of the OSs are very conservative and egotistic but not all

of them. Just look at the number of doctors that are becoming

believers sort to speak. Not as quickly as we would like but it is

happening. The bottom line is all of us have a responsibility in

this and not just the doctors which is why I am going to my one year

check ups and trying to be conservative in my activities and not

complain even though my surgery wasn't perfect.

Jeff

[Guest guest]

> > > I'm just trying to get the record straight here and am looking

> > > for verification or disqualification of this statement. I

believe

> > > that the reason why American Doctors are so conservative about

> > what

> > > they want their patients to do or not do is NOT because they

> don't

> > > trust the devices but because they want to see the devices get

> > > approved so that insurance companies will cover all of us

looking

> > to

> > > get a hip resurface.

> > >

> > > At least that is the impression that I got with Dr.

> > Kennedy

> > > and his group down in Sarasota, Florida. They loved the

devices

> > but

> > > want to go easy until this thing is FINALLY approved by the

FDA.

> > > The P.A. Mark in his office liked to share stories of people

> > pushing

> > > it past the limit even though he told me to go easy. One guy

for

> > > example worked on a fishing boat and invited Mark to come see

him

> > at

> > > work and go off-shore fishing for free basically. When Mark

> first

> > > got there he saw this patient who was 5 months after surgery

> slide

> > > down the mast of the boat and bounce off a cooler and jump on

the

> > > deck, smiling all the time and saying " works pretty good,

doesn't

> > > it? " . He told of another (a foot doctor) who went back to

work

> > > only 4 weeks after surgery and I went back to work after 4.5

> weeks.

> > >

> > > So once again I think the American doctors may be getting a

bum

> > rap

> > > for trying to look out for our best long term interests which

are

> > to

> > > get these things out there for all patients. Also, we have to

> > admit

> > > that the lawsuit frenzy in this country has some down sides.

> > >

> > > Jeff (01-03-03 C2K)

> > >

> > > P.S. I walked and jogged last night as I tried to imitate

normal

> > > Americans trying to get back in shape after making a New Years

> > > resolution.

My doctor in Orlando was part of the 1980 project and seems to be

scarred for life by that experience. Too bad.

Jeff

[Guest guest]

> > > I'm just trying to get the record straight here and am looking

> > > for verification or disqualification of this statement. I

believe

> > > that the reason why American Doctors are so conservative about

> > what

> > > they want their patients to do or not do is NOT because they

> don't

> > > trust the devices but because they want to see the devices get

> > > approved so that insurance companies will cover all of us

looking

> > to

> > > get a hip resurface.

> > >

> > > At least that is the impression that I got with Dr.

> > Kennedy

> > > and his group down in Sarasota, Florida. They loved the

devices

> > but

> > > want to go easy until this thing is FINALLY approved by the

FDA.

> > > The P.A. Mark in his office liked to share stories of people

> > pushing

> > > it past the limit even though he told me to go easy. One guy

for

> > > example worked on a fishing boat and invited Mark to come see

him

> > at

> > > work and go off-shore fishing for free basically. When Mark

> first

> > > got there he saw this patient who was 5 months after surgery

> slide

> > > down the mast of the boat and bounce off a cooler and jump on

the

> > > deck, smiling all the time and saying " works pretty good,

doesn't

> > > it? " . He told of another (a foot doctor) who went back to

work

> > > only 4 weeks after surgery and I went back to work after 4.5

> weeks.

> > >

> > > So once again I think the American doctors may be getting a

bum

> > rap

> > > for trying to look out for our best long term interests which

are

> > to

> > > get these things out there for all patients. Also, we have to

> > admit

> > > that the lawsuit frenzy in this country has some down sides.

> > >

> > > Jeff (01-03-03 C2K)

> > >

> > > P.S. I walked and jogged last night as I tried to imitate

normal

> > > Americans trying to get back in shape after making a New Years

> > > resolution.

My doctor in Orlando was part of the 1980 project and seems to be

scarred for life by that experience. Too bad.

Jeff

[Guest guest]

Jeff,

Imagine what it is like to be a doctor who tries a new technology

that on paper looks great but then has disastrous results with the

patients in substantial pain requiring a further round of

operations. I think that would scar anyone for life.

My surgeon in Texas like yours told me to leave it alone. He thought

I was an idiot to go ahead with the operation. I had however done my

research and had even spent an hour on the phone with the people at

MidMedtec talking about their prosthesis. Their conservative

approach impressed me. They took their time developing the hip and

did not distribute it until they had reasonable results.

So far I am pleased with my decision and when I have to have my left

hip done (I have hip dysplasia) I will be back in London visiting

Muirhead-Allwood again.

> > > > I'm just trying to get the record straight here and am looking

> > > > for verification or disqualification of this statement. I

> believe

> > > > that the reason why American Doctors are so conservative

about

> > > what

> > > > they want their patients to do or not do is NOT because they

> > don't

> > > > trust the devices but because they want to see the devices

get

> > > > approved so that insurance companies will cover all of us

> looking

> > > to

> > > > get a hip resurface.

> > > >

> > > > At least that is the impression that I got with Dr.

> > > Kennedy

> > > > and his group down in Sarasota, Florida. They loved the

> devices

> > > but

> > > > want to go easy until this thing is FINALLY approved by the

> FDA.

> > > > The P.A. Mark in his office liked to share stories of people

> > > pushing

> > > > it past the limit even though he told me to go easy. One guy

> for

> > > > example worked on a fishing boat and invited Mark to come see

> him

> > > at

> > > > work and go off-shore fishing for free basically. When Mark

> > first

> > > > got there he saw this patient who was 5 months after surgery

> > slide

> > > > down the mast of the boat and bounce off a cooler and jump on

> the

> > > > deck, smiling all the time and saying " works pretty good,

> doesn't

> > > > it? " . He told of another (a foot doctor) who went back to

> work

> > > > only 4 weeks after surgery and I went back to work after 4.5

> > weeks.

> > > >

> > > > So once again I think the American doctors may be getting a

> bum

> > > rap

> > > > for trying to look out for our best long term interests which

> are

> > > to

> > > > get these things out there for all patients. Also, we have

to

> > > admit

> > > > that the lawsuit frenzy in this country has some down sides.

> > > >

> > > > Jeff (01-03-03 C2K)

> > > >

> > > > P.S. I walked and jogged last night as I tried to imitate

> normal

> > > > Americans trying to get back in shape after making a New

Years

> > > > resolution.

>

> My doctor in Orlando was part of the 1980 project and seems to be

> scarred for life by that experience. Too bad.

>

> Jeff

[Guest guest]

Jeff,

Imagine what it is like to be a doctor who tries a new technology

that on paper looks great but then has disastrous results with the

patients in substantial pain requiring a further round of

operations. I think that would scar anyone for life.

My surgeon in Texas like yours told me to leave it alone. He thought

I was an idiot to go ahead with the operation. I had however done my

research and had even spent an hour on the phone with the people at

MidMedtec talking about their prosthesis. Their conservative

approach impressed me. They took their time developing the hip and

did not distribute it until they had reasonable results.

So far I am pleased with my decision and when I have to have my left

hip done (I have hip dysplasia) I will be back in London visiting

Muirhead-Allwood again.

> > > > I'm just trying to get the record straight here and am looking

> > > > for verification or disqualification of this statement. I

> believe

> > > > that the reason why American Doctors are so conservative

about

> > > what

> > > > they want their patients to do or not do is NOT because they

> > don't

> > > > trust the devices but because they want to see the devices

get

> > > > approved so that insurance companies will cover all of us

> looking

> > > to

> > > > get a hip resurface.

> > > >

> > > > At least that is the impression that I got with Dr.

> > > Kennedy

> > > > and his group down in Sarasota, Florida. They loved the

> devices

> > > but

> > > > want to go easy until this thing is FINALLY approved by the

> FDA.

> > > > The P.A. Mark in his office liked to share stories of people

> > > pushing

> > > > it past the limit even though he told me to go easy. One guy

> for

> > > > example worked on a fishing boat and invited Mark to come see

> him

> > > at

> > > > work and go off-shore fishing for free basically. When Mark

> > first

> > > > got there he saw this patient who was 5 months after surgery

> > slide

> > > > down the mast of the boat and bounce off a cooler and jump on

> the

> > > > deck, smiling all the time and saying " works pretty good,

> doesn't

> > > > it? " . He told of another (a foot doctor) who went back to

> work

> > > > only 4 weeks after surgery and I went back to work after 4.5

> > weeks.

> > > >

> > > > So once again I think the American doctors may be getting a

> bum

> > > rap

> > > > for trying to look out for our best long term interests which

> are

> > > to

> > > > get these things out there for all patients. Also, we have

to

> > > admit

> > > > that the lawsuit frenzy in this country has some down sides.

> > > >

> > > > Jeff (01-03-03 C2K)

> > > >

> > > > P.S. I walked and jogged last night as I tried to imitate

> normal

> > > > Americans trying to get back in shape after making a New

Years

> > > > resolution.

>

> My doctor in Orlando was part of the 1980 project and seems to be

> scarred for life by that experience. Too bad.

>

> Jeff

[Guest guest]

Jeff,

Imagine what it is like to be a doctor who tries a new technology

that on paper looks great but then has disastrous results with the

patients in substantial pain requiring a further round of

operations. I think that would scar anyone for life.

My surgeon in Texas like yours told me to leave it alone. He thought

I was an idiot to go ahead with the operation. I had however done my

research and had even spent an hour on the phone with the people at

MidMedtec talking about their prosthesis. Their conservative

approach impressed me. They took their time developing the hip and

did not distribute it until they had reasonable results.

So far I am pleased with my decision and when I have to have my left

hip done (I have hip dysplasia) I will be back in London visiting

Muirhead-Allwood again.

> > > > I'm just trying to get the record straight here and am looking

> > > > for verification or disqualification of this statement. I

> believe

> > > > that the reason why American Doctors are so conservative

about

> > > what

> > > > they want their patients to do or not do is NOT because they

> > don't

> > > > trust the devices but because they want to see the devices

get

> > > > approved so that insurance companies will cover all of us

> looking

> > > to

> > > > get a hip resurface.

> > > >

> > > > At least that is the impression that I got with Dr.

> > > Kennedy

> > > > and his group down in Sarasota, Florida. They loved the

> devices

> > > but

> > > > want to go easy until this thing is FINALLY approved by the

> FDA.

> > > > The P.A. Mark in his office liked to share stories of people

> > > pushing

> > > > it past the limit even though he told me to go easy. One guy

> for

> > > > example worked on a fishing boat and invited Mark to come see

> him

> > > at

> > > > work and go off-shore fishing for free basically. When Mark

> > first

> > > > got there he saw this patient who was 5 months after surgery

> > slide

> > > > down the mast of the boat and bounce off a cooler and jump on

> the

> > > > deck, smiling all the time and saying " works pretty good,

> doesn't

> > > > it? " . He told of another (a foot doctor) who went back to

> work

> > > > only 4 weeks after surgery and I went back to work after 4.5

> > weeks.

> > > >

> > > > So once again I think the American doctors may be getting a

> bum

> > > rap

> > > > for trying to look out for our best long term interests which

> are

> > > to

> > > > get these things out there for all patients. Also, we have

to

> > > admit

> > > > that the lawsuit frenzy in this country has some down sides.

> > > >

> > > > Jeff (01-03-03 C2K)

> > > >

> > > > P.S. I walked and jogged last night as I tried to imitate

> normal

> > > > Americans trying to get back in shape after making a New

Years

> > > > resolution.

>

> My doctor in Orlando was part of the 1980 project and seems to be

> scarred for life by that experience. Too bad.

>

> Jeff

[Guest guest]

<< The bottom line is all of us have a responsibility in

this and not just the doctors which is why I am going to my one year

check ups and trying to be conservative in my activities and not

complain even though my surgery wasn't perfect.

Jeff >>

Jeff

Hey!

I am one of Dr Kennedy's patients also. What exactly do you mean by . . .

" your surgury wasn't perfrect " ? You really have me scared here bud. Please

please reply

and . . . . . . as no man is an island - we all need each other here.

Thanks:-)

alyce

5/23/03

C2K

[Guest guest]

Hip Resurfacing WAS NOT pioneered in the UK!!!! This is a major

misconception that continues to be perpetuated. Dr. Amstutz and

several other surgeons from other international centers introduced hip

resurfacing in the 1974-1975 era. It is my recollection that none of

these centers were in the UK. Dr. Amstutz' first resurfacing system,

THARIES, was manufactured by Zimmer and widespread commercial use of

this system began in the 1978 timeframe.

It is true, however, that Drs. McMinn and Treacy in Birmingham, UK and

in collaboration with CORIN introduced the first metal-metal

resurfacing device in the 1991-1992 timeframe but the procedure itself

had been performed as early as 17-18 years previously.

Just thought I'd clarify that one point made in your previous posting.

Happy New Year!

Chuck

Executive Director

Joint Replacement Institute

Los Angeles

> > > I'm just trying to get the record straight here and am looking

> > > for verification or disqualification of this statement. I believe

> > > that the reason why American Doctors are so conservative about

> > what

> > > they want their patients to do or not do is NOT because they

> don't

> > > trust the devices but because they want to see the devices get

> > > approved so that insurance companies will cover all of us looking

> > to

> > > get a hip resurface.

> > >

> > > At least that is the impression that I got with Dr.

> > Kennedy

> > > and his group down in Sarasota, Florida. They loved the devices

> > but

> > > want to go easy until this thing is FINALLY approved by the FDA.

> > > The P.A. Mark in his office liked to share stories of people

> > pushing

> > > it past the limit even though he told me to go easy. One guy for

> > > example worked on a fishing boat and invited Mark to come see him

> > at

> > > work and go off-shore fishing for free basically. When Mark

> first

> > > got there he saw this patient who was 5 months after surgery

> slide

> > > down the mast of the boat and bounce off a cooler and jump on the

> > > deck, smiling all the time and saying " works pretty good, doesn't

> > > it? " . He told of another (a foot doctor) who went back to work

> > > only 4 weeks after surgery and I went back to work after 4.5

> weeks.

> > >

> > > So once again I think the American doctors may be getting a bum

> > rap

> > > for trying to look out for our best long term interests which are

> > to

> > > get these things out there for all patients. Also, we have to

> > admit

> > > that the lawsuit frenzy in this country has some down sides.

> > >

> > > Jeff (01-03-03 C2K)

> > >

> > > P.S. I walked and jogged last night as I tried to imitate normal

> > > Americans trying to get back in shape after making a New Years

> > > resolution.

[Guest guest]

Hip Resurfacing WAS NOT pioneered in the UK!!!! This is a major

misconception that continues to be perpetuated. Dr. Amstutz and

several other surgeons from other international centers introduced hip

resurfacing in the 1974-1975 era. It is my recollection that none of

these centers were in the UK. Dr. Amstutz' first resurfacing system,

THARIES, was manufactured by Zimmer and widespread commercial use of

this system began in the 1978 timeframe.

It is true, however, that Drs. McMinn and Treacy in Birmingham, UK and

in collaboration with CORIN introduced the first metal-metal

resurfacing device in the 1991-1992 timeframe but the procedure itself

had been performed as early as 17-18 years previously.

Just thought I'd clarify that one point made in your previous posting.

Happy New Year!

Chuck

Executive Director

Joint Replacement Institute

Los Angeles

> > > I'm just trying to get the record straight here and am looking

> > > for verification or disqualification of this statement. I believe

> > > that the reason why American Doctors are so conservative about

> > what

> > > they want their patients to do or not do is NOT because they

> don't

> > > trust the devices but because they want to see the devices get

> > > approved so that insurance companies will cover all of us looking

> > to

> > > get a hip resurface.

> > >

> > > At least that is the impression that I got with Dr.

> > Kennedy

> > > and his group down in Sarasota, Florida. They loved the devices

> > but

> > > want to go easy until this thing is FINALLY approved by the FDA.

> > > The P.A. Mark in his office liked to share stories of people

> > pushing

> > > it past the limit even though he told me to go easy. One guy for

> > > example worked on a fishing boat and invited Mark to come see him

> > at

> > > work and go off-shore fishing for free basically. When Mark

> first

> > > got there he saw this patient who was 5 months after surgery

> slide

> > > down the mast of the boat and bounce off a cooler and jump on the

> > > deck, smiling all the time and saying " works pretty good, doesn't

> > > it? " . He told of another (a foot doctor) who went back to work

> > > only 4 weeks after surgery and I went back to work after 4.5

> weeks.

> > >

> > > So once again I think the American doctors may be getting a bum

> > rap

> > > for trying to look out for our best long term interests which are

> > to

> > > get these things out there for all patients. Also, we have to

> > admit

> > > that the lawsuit frenzy in this country has some down sides.

> > >

> > > Jeff (01-03-03 C2K)

> > >

> > > P.S. I walked and jogged last night as I tried to imitate normal

> > > Americans trying to get back in shape after making a New Years

> > > resolution.

[Guest guest]

Hip Resurfacing WAS NOT pioneered in the UK!!!! This is a major

misconception that continues to be perpetuated. Dr. Amstutz and

several other surgeons from other international centers introduced hip

resurfacing in the 1974-1975 era. It is my recollection that none of

these centers were in the UK. Dr. Amstutz' first resurfacing system,

THARIES, was manufactured by Zimmer and widespread commercial use of

this system began in the 1978 timeframe.

It is true, however, that Drs. McMinn and Treacy in Birmingham, UK and

in collaboration with CORIN introduced the first metal-metal

resurfacing device in the 1991-1992 timeframe but the procedure itself

had been performed as early as 17-18 years previously.

Just thought I'd clarify that one point made in your previous posting.

Happy New Year!

Chuck

Executive Director

Joint Replacement Institute

Los Angeles

> > > I'm just trying to get the record straight here and am looking

> > > for verification or disqualification of this statement. I believe

> > > that the reason why American Doctors are so conservative about

> > what

> > > they want their patients to do or not do is NOT because they

> don't

> > > trust the devices but because they want to see the devices get

> > > approved so that insurance companies will cover all of us looking

> > to

> > > get a hip resurface.

> > >

> > > At least that is the impression that I got with Dr.

> > Kennedy

> > > and his group down in Sarasota, Florida. They loved the devices

> > but

> > > want to go easy until this thing is FINALLY approved by the FDA.

> > > The P.A. Mark in his office liked to share stories of people

> > pushing

> > > it past the limit even though he told me to go easy. One guy for

> > > example worked on a fishing boat and invited Mark to come see him

> > at

> > > work and go off-shore fishing for free basically. When Mark

> first

> > > got there he saw this patient who was 5 months after surgery

> slide

> > > down the mast of the boat and bounce off a cooler and jump on the

> > > deck, smiling all the time and saying " works pretty good, doesn't

> > > it? " . He told of another (a foot doctor) who went back to work

> > > only 4 weeks after surgery and I went back to work after 4.5

> weeks.

> > >

> > > So once again I think the American doctors may be getting a bum

> > rap

> > > for trying to look out for our best long term interests which are

> > to

> > > get these things out there for all patients. Also, we have to

> > admit

> > > that the lawsuit frenzy in this country has some down sides.

> > >

> > > Jeff (01-03-03 C2K)

> > >

> > > P.S. I walked and jogged last night as I tried to imitate normal

> > > Americans trying to get back in shape after making a New Years

> > > resolution.

[Guest guest]

I would just like to point out that it is a misconception that the UK is way

behind in quality and technology - the World Health Organisation's ranking of

the World's health systems ranks us as 18th with the USA 37th - source

http://www.photius.com/rankings/healthranks.html

Rog

Re: Why American Doctors Cringe - Setting The Record

Straight

There are severalreasons why American doctors are so resistant to

this concept. The first is the disastrous experience with the

original resurfacings back in the 1970/80s when they used teflon

liners. The hips failed in so many ways and so quickly that the

concept was quickly discarded. At that time the accepted THR device

was the Charnley hip that also had a teflon liner but these hips

seemed to last longer than the resurfacing hips in large part because

of the smaller size of the acetabular head. As a result hip

resurfacing was viewed as an invalid concept. The problem of course

was with the teflon liner not the concept. Nevertheless most most US

surgeons continue to view the resurfacing concept with a great deal

of scepticism.

The second problem is what I call the " not invented here " problem.

Hip resurfacing has been pioneered in the UK. For most American

doctors health care in the UK comes nowhere near the level of

technology and quality of care found in the US. As a result it is

difficult for them to accept the idea that good technolgy can and has

been developed in the UK. If the concept had been pioneered in the

US it would be a different story.

The final reason is the litigious nature of the USA. With rapidly

increasing malpractice insurance costs doctors are well aware of the

risks they face in embracing new " doubtful " technology particularly

technology that has failed in the past. In some ways you can't blame

them.

By the way I am a 3 year veteran of a BHR carried out at Princess

Grace Hospital in London by Muirhead-Allwood. My hip is

perfect and I am functioning normally and have had no post-op

problems. A recent survey of all BHRs carried out by showed

95% of the recipients were functioning at a normal level. is

an extraordinary surgeon and one of the top hip surgeons in the world

(she did the Queen Mother's hip). As a result she is difficult to

get an appointment with but well worth the wait. In 2001 the total

cost was GBP12,000

> > I'm just trying to get the record straight here and am looking

> > for verification or disqualification of this statement. I believe

> > that the reason why American Doctors are so conservative about

> what

> > they want their patients to do or not do is NOT because they

don't

> > trust the devices but because they want to see the devices get

> > approved so that insurance companies will cover all of us looking

> to

> > get a hip resurface.

> >

> > At least that is the impression that I got with Dr.

> Kennedy

> > and his group down in Sarasota, Florida. They loved the devices

> but

> > want to go easy until this thing is FINALLY approved by the FDA.

> > The P.A. Mark in his office liked to share stories of people

> pushing

> > it past the limit even though he told me to go easy. One guy for

> > example worked on a fishing boat and invited Mark to come see him

> at

> > work and go off-shore fishing for free basically. When Mark

first

> > got there he saw this patient who was 5 months after surgery

slide

> > down the mast of the boat and bounce off a cooler and jump on the

> > deck, smiling all the time and saying " works pretty good, doesn't

> > it? " . He told of another (a foot doctor) who went back to work

> > only 4 weeks after surgery and I went back to work after 4.5

weeks.

> >

> > So once again I think the American doctors may be getting a bum

> rap

> > for trying to look out for our best long term interests which are

> to

> > get these things out there for all patients. Also, we have to

> admit

> > that the lawsuit frenzy in this country has some down sides.

> >

> > Jeff (01-03-03 C2K)

> >

> > P.S. I walked and jogged last night as I tried to imitate normal

> > Americans trying to get back in shape after making a New Years

> > resolution.

------------------------------------------------------------------------------

[Guest guest]

In the Late 1950's Sir Charnley FRS started it alll when he

began resurfacing hips with Teflon components. (This was the new wonder material

of the age and was known to have a low friction co-efficient. Sadly it had awful

wear properties). Even at this time he appreciated that for patients with

arthritic hips it made sense to only replace the diseased bone surfaces rather

than to make a radical resection of the femoral head and neck if at all

possible.It was also obvious that such a conservative approach would largely

leave the natural offset and anteversion of the hip joint intact and, by using

an anatomically sized ball and socket, virtually eliminates the problems of

dislocation and leg length dscrepancy associated with susequent stemmed hip

prostheses. (At the same time McKee et al were experimenting with metal on metal

devices)

The concept was absolutely right the material he chose was a

disaster. He went off to consider smaller bearings, first with teflon and then

with plastic both of which precluded the resurfacing concept.

The concept was resurected in the 1970s largely by prof H Wagner in

Germany and Mr M.A.R. Freeman FRCS in the UK who both used metal on plastic

bearings . Although they produced excellent initial outcomes, which encouraged

large numbers to be implanted in a relatively short time, they began to fail

catastrophically at 4-6-years with a mean survival of arround 50% at 6 years.

This was initially thought to be caused by devascularisation of the femoral head

and neck causing femoral neck fractures. Subsequent histological studies

however, have shown that this was, in fact, caused by excessive volumetric

plastic wear osteolysis, which in hindsight, we have learnt is a direct

consequence of large diameter metal/ plastic bearings.The idea was once again

abandonned.

In the 1980's Prof H Amstutz (USA) resurrected metal on plastic

resurfacings with largely the same result but at the same time initiated a

series of hemi-resurfacing arthroplasties. It was apparent that these femoral

head components, in the absence of plastic, did not suffer neck fractures and

had a very high survivorship at 15 years.

Largely because of this and the fact that it was now known that

metal on metal hip bearings, if manufactured tolerably well, could survive

indefinately, hip resurfacing, was once again resurrected. Mr D. McMinn FRCS in

England and Prof H Wagner in Germany both began implanting experimental metal on

metal resufacing devices in 1991.(Such bearings had been used for almost 40

years and it had become apparent that the long term survivorship of both the

McKee Farrar's and The Ring' metal on metal implants were at least as good as

the metal on plastic 'Charnley' implants which by this time, had become the gold

standard for hip arthroplasty. (although the mechanism for failure and the

temporal profiles for such failure were completely different).

The early experiences of this resurrection was inauspicious to say

the least . Prof H Wagner used a forged cobalt chrome liner inset into a

titanium outer shell for the acetabular component and a stemless femoral

component and for whatever reasons relatively few were made or implanted. Mr D

McMinn FRCS used a variety of different microstructural forms of the cast cobalt

chrome alloy with a number of diferent shell geometries and a stemmed femoral

component with a number of different fixation systems. However, again for

whatever reasons, the The 'McMinn' resurfacing as it was known was abandoned and

withdrawn from the market at the end of 1996.

In 1996 I established Midland Medical Technologies Ltd with surgeon

backing to research all the technologies required to make a workable metal on

metal hip resurfacing device. I defined the required metalurgical chemistry and

microstructure from analysis of successful explanted 'Ring' Impants that had

survived in situ for more than 25 years, defined the optimal radial mismatch of

head and cup and roundness tolerance requirements for such a bearing to work and

employed a fixation system that was known to work effectively. The result of

this work was the specification and subsequent introduction of the Birmingham

hip resurfacing (BHR) in July 1997.

The rest is history. We had produced an implant which was shown to

be working extremely well with far fewer early complications and failures than

any traditional total hip and this in a young and relatively active patient

group (average patient age approx 50 years) for whom traditional total hip

arthroplasty is not a particularly attractive option. In short we had shown that

Hip resurfacing could work and offer the theoretical benefits it had always

promised but until now had failed to deliver.

.

As a result of the success achieved with this first attempt in the

UK It was an obvious step to introduce this concept to Europe, and where better

to get such a device engineered than in Germany. The result is the Icon Hip

resurfacing manufactured by IO International Orthopaedics GMBH

The Icon Hip has all the features you would expect of a

comprehensive hip resurfacing system including a full range of sizes,a dysplasia

cup option and a full range of modular heads. We believe we have made a number

of distinct improvements to both the implant and its instrumentation to make it

more user friendly. To address the issue of bone next to Chobalt Chrome (CoCr)

the acetabular components are treated with a Titanium Nitride (TiN) coating

prior to being coated with Hydroxyapatite (HA) so that in the likely event that

the HA eventually becomes absorbed over time, bone is not exposed to Cobalt

Chrome, which we know, can inhibit bone growth.

We have not compromised on the critical dimensions, specifications

and tolerances which we know work so well. The High Carbon Cobalt Chrome is in

the'as cast' state and the surface beading is cast and thus is integral with the

shell.

With regard to instrumentation we have a patented cup introducer

system which is both simple and far less bulky than previous designs allowing

better visualisation of placement of the cup during impaction The system also

works for extraction without the need for fiddly wires.

We are also pleased to be able to offer a completely new Minimally

invasive approach to this operation . Developed and patented By Mr G Chana FRCS

and utilising some very clever instrumentation, the complete procedure can now

be carried out through a 7-11 cm incision (rather than the normal 20-30 cm)

without the need to divide the gluteus maximus. This is a major step forward. It

makes obvious sense when performing a conservative arthroplasty with the

intention of producing excellent functional outcomes to do as little damage to

the soft tissues as possible during the process. It results in considerably

reduced blood loss, leads to faster recovery and rehabilitation for the patient

and almost eliminates the need for post operative blood transfusion (2 units is

usual for total hip arthroplasty)

We believe, that in time, as this technique becomes familiar with

surgeons, it will lead inevitably to a significant reduction in average post

operative patient days in hospital and thereby eventually result in huge savings

for healthcare providers.

The Icon Hip is the result of many years experience with hip

resurfacing arthroplasty, a logical next step in the development of hip

resurfacing and offers unique benefits for surgeons and patients alike

Bob Parsons was formerly the Managing Director of Midland Medical

Technologies Ltd and is currently Geschaftsfuhrer of IO International

Orthopaedics gmbh and managing director of International Orthopaedics Ltd.

http://www.iconhip.com/history.htm

The above is one of many sites that would contradict you Chuck - I

can find loads - Dr Amstutz is honoured and recognised in the UK for his work

and I am not denying his place in the history books. It depends what you mean

by 'pioneered' and depends on who writes the history.

Rog

Re: Why American Doctors Cringe - Setting The Record

Straight

Hip Resurfacing WAS NOT pioneered in the UK!!!! This is a major

misconception that continues to be perpetuated. Dr. Amstutz and

several other surgeons from other international centers introduced hip

resurfacing in the 1974-1975 era. It is my recollection that none of

these centers were in the UK. Dr. Amstutz' first resurfacing system,

THARIES, was manufactured by Zimmer and widespread commercial use of

this system began in the 1978 timeframe.

It is true, however, that Drs. McMinn and Treacy in Birmingham, UK and

in collaboration with CORIN introduced the first metal-metal

resurfacing device in the 1991-1992 timeframe but the procedure itself

had been performed as early as 17-18 years previously.

Just thought I'd clarify that one point made in your previous posting.

Happy New Year!

Chuck

Executive Director

Joint Replacement Institute

Los Angeles

> > > I'm just trying to get the record straight here and am looking

> > > for verification or disqualification of this statement. I believe

> > > that the reason why American Doctors are so conservative about

> > what

> > > they want their patients to do or not do is NOT because they

> don't

> > > trust the devices but because they want to see the devices get

> > > approved so that insurance companies will cover all of us looking

> > to

> > > get a hip resurface.

> > >

> > > At least that is the impression that I got with Dr.

> > Kennedy

> > > and his group down in Sarasota, Florida. They loved the devices

> > but

> > > want to go easy until this thing is FINALLY approved by the FDA.

> > > The P.A. Mark in his office liked to share stories of people

> > pushing

> > > it past the limit even though he told me to go easy. One guy for

> > > example worked on a fishing boat and invited Mark to come see him

> > at

> > > work and go off-shore fishing for free basically. When Mark

> first

> > > got there he saw this patient who was 5 months after surgery

> slide

> > > down the mast of the boat and bounce off a cooler and jump on the

> > > deck, smiling all the time and saying " works pretty good, doesn't

> > > it? " . He told of another (a foot doctor) who went back to work

> > > only 4 weeks after surgery and I went back to work after 4.5

> weeks.

> > >

> > > So once again I think the American doctors may be getting a bum

> > rap

> > > for trying to look out for our best long term interests which are

> > to

> > > get these things out there for all patients. Also, we have to

> > admit

> > > that the lawsuit frenzy in this country has some down sides.

> > >

> > > Jeff (01-03-03 C2K)

> > >

> > > P.S. I walked and jogged last night as I tried to imitate normal

> > > Americans trying to get back in shape after making a New Years

> > > resolution.

[Guest guest]

<< To address the issue of bone next to Chobalt Chrome (CoCr) the acetabular

components are treated with a Titanium Nitride (TiN) coating prior to being

coated with Hydroxyapatite (HA) so that in the likely event that the HA

eventually becomes absorbed over time, bone is not exposed to Cobalt Chrome,

which we

know, can inhibit bone growth. >>

.. . .and/or any one who mihgt know. . .

Do the " other " prosthetics, the C+ and the Corin C2K, have this type

of lining o insue healthy bone under the femoral component?

Thanks

Alyce

LC2K 5/23/03

[Guest guest]

Good to see Chuck is still reading this Board. Thanks for

contributing.

Brad Buchan

Spencertown, NY

Mont C+, Rt 12/20/00, Lt 1/3

/01

Re: Why American Doctors Cringe - Setting The Record

Straight

> Hip Resurfacing WAS NOT pioneered in the UK!!!! This is a major

> misconception that continues to be perpetuated. Dr. Amstutz and

> several other surgeons from other international centers introduced hip

> resurfacing in the 1974-1975 era. It is my recollection that none of

> these centers were in the UK. Dr. Amstutz' first resurfacing system,

> THARIES, was manufactured by Zimmer and widespread commercial use of

> this system began in the 1978 timeframe.

>

> It is true, however, that Drs. McMinn and Treacy in Birmingham, UK and

> in collaboration with CORIN introduced the first metal-metal

> resurfacing device in the 1991-1992 timeframe but the procedure itself

> had been performed as early as 17-18 years previously.

>

> Just thought I'd clarify that one point made in your previous posting.

>

> Happy New Year!

>

> Chuck

> Executive Director

> Joint Replacement Institute

> Los Angeles

>

>

>

>

> > > > I'm just trying to get the record straight here and am looking

> > > > for verification or disqualification of this statement. I believe

> > > > that the reason why American Doctors are so conservative about

> > > what

> > > > they want their patients to do or not do is NOT because they

> > don't

> > > > trust the devices but because they want to see the devices get

> > > > approved so that insurance companies will cover all of us looking

> > > to

> > > > get a hip resurface.

> > > >

> > > > At least that is the impression that I got with Dr.

> > > Kennedy

> > > > and his group down in Sarasota, Florida. They loved the devices

> > > but

> > > > want to go easy until this thing is FINALLY approved by the FDA.

> > > > The P.A. Mark in his office liked to share stories of people

> > > pushing

> > > > it past the limit even though he told me to go easy. One guy for

> > > > example worked on a fishing boat and invited Mark to come see him

> > > at

> > > > work and go off-shore fishing for free basically. When Mark

> > first

> > > > got there he saw this patient who was 5 months after surgery

> > slide

> > > > down the mast of the boat and bounce off a cooler and jump on the

> > > > deck, smiling all the time and saying " works pretty good, doesn't

> > > > it? " . He told of another (a foot doctor) who went back to work

> > > > only 4 weeks after surgery and I went back to work after 4.5

> > weeks.

> > > >

> > > > So once again I think the American doctors may be getting a bum

> > > rap

> > > > for trying to look out for our best long term interests which are

> > > to

> > > > get these things out there for all patients. Also, we have to

> > > admit

> > > > that the lawsuit frenzy in this country has some down sides.

> > > >

> > > > Jeff (01-03-03 C2K)

> > > >

> > > > P.S. I walked and jogged last night as I tried to imitate normal

> > > > Americans trying to get back in shape after making a New Years

> > > > resolution.

>

>

>

>

>

>

[Guest guest]

Hi, Rog!

Happy New Year to you!

Technically, it is true that Charnley " experimented " with resurfacing

but he did not pursue it in any serious way which is why he is not

credited with the development of resurfacing. Technically, the first

who did was Dr. Trantieri in Italy in 1973. The other surgeons

developing resurfacing systems inn the early 70's included Amstutz

(US), Mueller (Switzerland), Wagner (Germany), Freeman (UK) and Eicher

(US).

An interesting " aside " : Amstutz' " chamfered cylinder " design of the

femoral shell (THARIES) became the standard and all subsequent designs

have essentially copied this concept including McMinn's first CORIN

device as well as the BHR device.

All the best!

Chuck

JRI

> > > > I'm just trying to get the record straight here and am looking

> > > > for verification or disqualification of this statement. I

believe

> > > > that the reason why American Doctors are so conservative about

> > > what

> > > > they want their patients to do or not do is NOT because they

> > don't

> > > > trust the devices but because they want to see the devices get

> > > > approved so that insurance companies will cover all of us

looking

> > > to

> > > > get a hip resurface.

> > > >

> > > > At least that is the impression that I got with Dr.

> > > Kennedy

> > > > and his group down in Sarasota, Florida. They loved the

devices

> > > but

> > > > want to go easy until this thing is FINALLY approved by the FDA.

> > > > The P.A. Mark in his office liked to share stories of people

> > > pushing

> > > > it past the limit even though he told me to go easy. One

guy for

> > > > example worked on a fishing boat and invited Mark to come

see him

> > > at

> > > > work and go off-shore fishing for free basically. When Mark

> > first

> > > > got there he saw this patient who was 5 months after surgery

> > slide

> > > > down the mast of the boat and bounce off a cooler and jump

on the

> > > > deck, smiling all the time and saying " works pretty good,

doesn't

> > > > it? " . He told of another (a foot doctor) who went back to work

> > > > only 4 weeks after surgery and I went back to work after 4.5

> > weeks.

> > > >

> > > > So once again I think the American doctors may be getting a bum

> > > rap

> > > > for trying to look out for our best long term interests

which are

> > > to

> > > > get these things out there for all patients. Also, we have to

> > > admit

> > > > that the lawsuit frenzy in this country has some down sides.

> > > >

> > > > Jeff (01-03-03 C2K)

> > > >

> > > > P.S. I walked and jogged last night as I tried to imitate

normal

> > > > Americans trying to get back in shape after making a New Years

> > > > resolution.

>

>

>

[Guest guest]

>

> In a message dated 1/7/04 2:21:10 PM, jeff83deb2002@y... writes:

>

> << The bottom line is all of us have a responsibility in

>

> this and not just the doctors which is why I am going to my one

year

>

> check ups and trying to be conservative in my activities and not

>

> complain even though my surgery wasn't perfect.

>

>

> Jeff >>

>

> Jeff

> Hey!

> I am one of Dr Kennedy's patients also. What exactly do you mean

by . . .

> " your surgury wasn't perfrect " ? You really have me scared here

bud. Please

> please reply

> and . . . . . . as no man is an island - we all need each

other here.

> Thanks:-)

> alyce

> 5/23/03

> C2K

Don't be scared, the device was placed perfectly in me. The

problem that I have is something that like one or two people

have discussed and it isn't from one particular doctor. I have

had a tender iliad-tibial tendon since surgery. It is getting

better but it is a slow process. I have maintained a

conservative approach to exercise because my leg gets tight

on the outside of my knee when I do alot of activity. It is

getting better but I still have a slight problem. I don't

have any joint pain anymore which allows me to walk alot which

I couldn't do before and my limp is just about all gone. When

I run around and play basketball with the kids I can feel my

knee area tighten the next day. Heat will help the tightness to go

away or resting a few days does the same thing but I don't think

about the tightness during the day when I'm doing normal stuff.

Jeff

[Guest guest]

And so why is the backing material different?

I understand the C+ is bead backed with (?) with a heat treated (sintered)

bead made of (?) and why is it a different material and treatment from the

Birmingham?

NO ARGUMENT- just want to know the rationale, AND I know that there is not

yet data to prove one over the other- just want to know how come?

Dave

Boyd C+

12/18/03

>

> Reply-To: surfacehippy

> Date: Thu, 08 Jan 2004 19:59:22 -0000

> To: surfacehippy

> Subject: Re: Why American Doctors Cringe - Setting The Record

> Straight

>

> Hi, Rog!

>

> Happy New Year to you!

>

> Technically, it is true that Charnley " experimented " with resurfacing

> but he did not pursue it in any serious way which is why he is not

> credited with the development of resurfacing. Technically, the first

> who did was Dr. Trantieri in Italy in 1973. The other surgeons

> developing resurfacing systems inn the early 70's included Amstutz

> (US), Mueller (Switzerland), Wagner (Germany), Freeman (UK) and Eicher

> (US).

>

> An interesting " aside " : Amstutz' " chamfered cylinder " design of the

> femoral shell (THARIES) became the standard and all subsequent designs

> have essentially copied this concept including McMinn's first CORIN

> device as well as the BHR device.

>

> All the best!

>

> Chuck

> JRI

>

>

>>>>> I'm just trying to get the record straight here and am looking

>>>>> for verification or disqualification of this statement. I

> believe

>>>>> that the reason why American Doctors are so conservative about

>>>> what

>>>>> they want their patients to do or not do is NOT because they

>>> don't

>>>>> trust the devices but because they want to see the devices get

>>>>> approved so that insurance companies will cover all of us

> looking

>>>> to

>>>>> get a hip resurface.

>>>>>

>>>>> At least that is the impression that I got with Dr.

>>>> Kennedy

>>>>> and his group down in Sarasota, Florida. They loved the

> devices

>>>> but

>>>>> want to go easy until this thing is FINALLY approved by the FDA.

>>>>> The P.A. Mark in his office liked to share stories of people

>>>> pushing

>>>>> it past the limit even though he told me to go easy. One

> guy for

>>>>> example worked on a fishing boat and invited Mark to come

> see him

>>>> at

>>>>> work and go off-shore fishing for free basically. When Mark

>>> first

>>>>> got there he saw this patient who was 5 months after surgery

>>> slide

>>>>> down the mast of the boat and bounce off a cooler and jump

> on the

>>>>> deck, smiling all the time and saying " works pretty good,

> doesn't

>>>>> it? " . He told of another (a foot doctor) who went back to work

>>>>> only 4 weeks after surgery and I went back to work after 4.5

>>> weeks.

>>>>>

>>>>> So once again I think the American doctors may be getting a bum

>>>> rap

>>>>> for trying to look out for our best long term interests

> which are

>>>> to

>>>>> get these things out there for all patients. Also, we have to

>>>> admit

>>>>> that the lawsuit frenzy in this country has some down sides.

>>>>>

>>>>> Jeff (01-03-03 C2K)

>>>>>

>>>>> P.S. I walked and jogged last night as I tried to imitate

> normal

>>>>> Americans trying to get back in shape after making a New Years

>>>>> resolution.

>>

>>

>>

[Guest guest]

And so why is the backing material different?

I understand the C+ is bead backed with (?) with a heat treated (sintered)

bead made of (?) and why is it a different material and treatment from the

Birmingham?

NO ARGUMENT- just want to know the rationale, AND I know that there is not

yet data to prove one over the other- just want to know how come?

Dave

Boyd C+

12/18/03

>

> Reply-To: surfacehippy

> Date: Thu, 08 Jan 2004 19:59:22 -0000

> To: surfacehippy

> Subject: Re: Why American Doctors Cringe - Setting The Record

> Straight

>

> Hi, Rog!

>

> Happy New Year to you!

>

> Technically, it is true that Charnley " experimented " with resurfacing

> but he did not pursue it in any serious way which is why he is not

> credited with the development of resurfacing. Technically, the first

> who did was Dr. Trantieri in Italy in 1973. The other surgeons

> developing resurfacing systems inn the early 70's included Amstutz

> (US), Mueller (Switzerland), Wagner (Germany), Freeman (UK) and Eicher

> (US).

>

> An interesting " aside " : Amstutz' " chamfered cylinder " design of the

> femoral shell (THARIES) became the standard and all subsequent designs

> have essentially copied this concept including McMinn's first CORIN

> device as well as the BHR device.

>

> All the best!

>

> Chuck

> JRI

>

>

>>>>> I'm just trying to get the record straight here and am looking

>>>>> for verification or disqualification of this statement. I

> believe

>>>>> that the reason why American Doctors are so conservative about

>>>> what

>>>>> they want their patients to do or not do is NOT because they

>>> don't

>>>>> trust the devices but because they want to see the devices get

>>>>> approved so that insurance companies will cover all of us

> looking

>>>> to

>>>>> get a hip resurface.

>>>>>

>>>>> At least that is the impression that I got with Dr.

>>>> Kennedy

>>>>> and his group down in Sarasota, Florida. They loved the

> devices

>>>> but

>>>>> want to go easy until this thing is FINALLY approved by the FDA.

>>>>> The P.A. Mark in his office liked to share stories of people

>>>> pushing

>>>>> it past the limit even though he told me to go easy. One

> guy for

>>>>> example worked on a fishing boat and invited Mark to come

> see him

>>>> at

>>>>> work and go off-shore fishing for free basically. When Mark

>>> first

>>>>> got there he saw this patient who was 5 months after surgery

>>> slide

>>>>> down the mast of the boat and bounce off a cooler and jump

> on the

>>>>> deck, smiling all the time and saying " works pretty good,

> doesn't

>>>>> it? " . He told of another (a foot doctor) who went back to work

>>>>> only 4 weeks after surgery and I went back to work after 4.5

>>> weeks.

>>>>>

>>>>> So once again I think the American doctors may be getting a bum

>>>> rap

>>>>> for trying to look out for our best long term interests

> which are

>>>> to

>>>>> get these things out there for all patients. Also, we have to

>>>> admit

>>>>> that the lawsuit frenzy in this country has some down sides.

>>>>>

>>>>> Jeff (01-03-03 C2K)

>>>>>

>>>>> P.S. I walked and jogged last night as I tried to imitate

> normal

>>>>> Americans trying to get back in shape after making a New Years

>>>>> resolution.

>>

>>

>>

[Guest guest]

And so why is the backing material different?

I understand the C+ is bead backed with (?) with a heat treated (sintered)

bead made of (?) and why is it a different material and treatment from the

Birmingham?

NO ARGUMENT- just want to know the rationale, AND I know that there is not

yet data to prove one over the other- just want to know how come?

Dave

Boyd C+

12/18/03

>

> Reply-To: surfacehippy

> Date: Thu, 08 Jan 2004 19:59:22 -0000

> To: surfacehippy

> Subject: Re: Why American Doctors Cringe - Setting The Record

> Straight

>

> Hi, Rog!

>

> Happy New Year to you!

>

> Technically, it is true that Charnley " experimented " with resurfacing

> but he did not pursue it in any serious way which is why he is not

> credited with the development of resurfacing. Technically, the first

> who did was Dr. Trantieri in Italy in 1973. The other surgeons

> developing resurfacing systems inn the early 70's included Amstutz

> (US), Mueller (Switzerland), Wagner (Germany), Freeman (UK) and Eicher

> (US).

>

> An interesting " aside " : Amstutz' " chamfered cylinder " design of the

> femoral shell (THARIES) became the standard and all subsequent designs

> have essentially copied this concept including McMinn's first CORIN

> device as well as the BHR device.

>

> All the best!

>

> Chuck

> JRI

>

>

>>>>> I'm just trying to get the record straight here and am looking

>>>>> for verification or disqualification of this statement. I

> believe

>>>>> that the reason why American Doctors are so conservative about

>>>> what

>>>>> they want their patients to do or not do is NOT because they

>>> don't

>>>>> trust the devices but because they want to see the devices get

>>>>> approved so that insurance companies will cover all of us

> looking

>>>> to

>>>>> get a hip resurface.

>>>>>

>>>>> At least that is the impression that I got with Dr.

>>>> Kennedy

>>>>> and his group down in Sarasota, Florida. They loved the

> devices

>>>> but

>>>>> want to go easy until this thing is FINALLY approved by the FDA.

>>>>> The P.A. Mark in his office liked to share stories of people

>>>> pushing

>>>>> it past the limit even though he told me to go easy. One

> guy for

>>>>> example worked on a fishing boat and invited Mark to come

> see him

>>>> at

>>>>> work and go off-shore fishing for free basically. When Mark

>>> first

>>>>> got there he saw this patient who was 5 months after surgery

>>> slide

>>>>> down the mast of the boat and bounce off a cooler and jump

> on the

>>>>> deck, smiling all the time and saying " works pretty good,

> doesn't

>>>>> it? " . He told of another (a foot doctor) who went back to work

>>>>> only 4 weeks after surgery and I went back to work after 4.5

>>> weeks.

>>>>>

>>>>> So once again I think the American doctors may be getting a bum

>>>> rap

>>>>> for trying to look out for our best long term interests

> which are

>>>> to

>>>>> get these things out there for all patients. Also, we have to

>>>> admit

>>>>> that the lawsuit frenzy in this country has some down sides.

>>>>>

>>>>> Jeff (01-03-03 C2K)

>>>>>

>>>>> P.S. I walked and jogged last night as I tried to imitate

> normal

>>>>> Americans trying to get back in shape after making a New Years

>>>>> resolution.

>>

>>

>>

[Guest guest]

Hi Chuck

Happy New Year to you!

Charnley did resurfacing operations in the 50's using Teflon on Teflon bearings

- they failed after 2 years. This is why the UK is acknowledged as the first

country to do resurfacing as indeed it was with THR through Wiles in the

1930's. Hip operations before this were unsatisfactory as only one arthritic

surface was replaced.

The concepts were theirs and so they should be remembered as such.

One of Wiles hips lasted 30+ years - not bad and I'm sure we all would be happy

with this.

McKee was a trainee with Wiles incidentally.

All the OS's you mention are worthy of credit and no doubt there will be more to

come - we are still in the early days of MOM resurfacing.

Rog

Re: Why American Doctors Cringe - Setting The Record

Straight

Hi, Rog!

Happy New Year to you!

Technically, it is true that Charnley " experimented " with resurfacing

but he did not pursue it in any serious way which is why he is not

credited with the development of resurfacing. Technically, the first

who did was Dr. Trantieri in Italy in 1973. The other surgeons

developing resurfacing systems inn the early 70's included Amstutz

(US), Mueller (Switzerland), Wagner (Germany), Freeman (UK) and Eicher

(US).

An interesting " aside " : Amstutz' " chamfered cylinder " design of the

femoral shell (THARIES) became the standard and all subsequent designs

have essentially copied this concept including McMinn's first CORIN

device as well as the BHR device.

All the best!

Chuck

JRI

> > > > I'm just trying to get the record straight here and am looking

> > > > for verification or disqualification of this statement. I

believe

> > > > that the reason why American Doctors are so conservative about

> > > what

> > > > they want their patients to do or not do is NOT because they

> > don't

> > > > trust the devices but because they want to see the devices get

> > > > approved so that insurance companies will cover all of us

looking

> > > to

> > > > get a hip resurface.

> > > >

> > > > At least that is the impression that I got with Dr.

> > > Kennedy

> > > > and his group down in Sarasota, Florida. They loved the

devices

> > > but

> > > > want to go easy until this thing is FINALLY approved by the FDA.

> > > > The P.A. Mark in his office liked to share stories of people

> > > pushing

> > > > it past the limit even though he told me to go easy. One

guy for

> > > > example worked on a fishing boat and invited Mark to come

see him

> > > at

> > > > work and go off-shore fishing for free basically. When Mark

> > first

> > > > got there he saw this patient who was 5 months after surgery

> > slide

> > > > down the mast of the boat and bounce off a cooler and jump

on the

> > > > deck, smiling all the time and saying " works pretty good,

doesn't

> > > > it? " . He told of another (a foot doctor) who went back to work

> > > > only 4 weeks after surgery and I went back to work after 4.5

> > weeks.

> > > >

> > > > So once again I think the American doctors may be getting a bum

> > > rap

> > > > for trying to look out for our best long term interests

which are

> > > to

> > > > get these things out there for all patients. Also, we have to

> > > admit

> > > > that the lawsuit frenzy in this country has some down sides.

> > > >

> > > > Jeff (01-03-03 C2K)

> > > >

> > > > P.S. I walked and jogged last night as I tried to imitate

normal

> > > > Americans trying to get back in shape after making a New Years

> > > > resolution.

>

>

>