Re: Re: Anybody speak Belgium-ese?

May 3, 2004

Hi Greg,

Back several months ago laid out wonderful well a lot about the

business of cement under the femoral cap......... you may like to go find it

in his words............Actually I guess we should have some of these gems

in a special place.......... or we may do and I don't realise

that...........

There is one version I think Corin make without cement but not too many seem

to have tried it............ As I understand it, it has a bit to do with

how long it would take you to ever get walking on it again without

cement....... And the fact that it seems that the cement issue was a

furphy, that doctors later found it was the bits of plastic rather than

cement that was causing the hassles that they were finding and initially

attributing to cement.......... Then with the Resurface it isn't the cement

that causes the loosening in general........ if they come loose it is the

bone dying under the cap for one reason or another and fractures at time of

operation seems to be what is turning up here in Australia as No 1 culprit

for that.......i.e. surgeons with heavy hands behind hammers...........

In general the cement coming loose is a THR problem and the whole thing is

quite different because the stress is on the fixing cement within the shaft

of the bone with that prothesis.......... i.e. that prothesis requires that

either the bone grows solid around that metal shaft or you fill up the femur

marrow area with cement............the stress of the use of the joint

happens in that area so it is under constant stress............... In a

Resurface the cement is smeared over what's left of the femur head, thereby

filling cevises and helping bonding and there simply isn't the same role

played when it comes to stress and holding for the hip swings on the ball as

it does normally and the stress loading goes down into the natural femur

bone left ............. with emphasis on that's how I understand it.........

but you can work it out yourself by thinking about how your hip bones/joints

actually work and what is removed in each op.......

Edith LBHR Dr. L Walter Syd Aust 8/02

> Thanks for your responses. June, it sounds like we are getting the same

reaction from people about a trip to Belgium. Everybody thinks I am making

a HUGE mistake to leave a country that has the best that medical technology

can offer to go to Belgium. I don't know what they do differently, or the

same, in Belgium.

>

> When I went to Dr. De Smet's website, under the education icon, only a

blank screen came up. I wasn't accusing him of not being qualified, but I

just couldn't find out what his educational background was.

>

> On a seperate question: Do any of you know why cement is used for the

femoral cap? The acetabular cap is press-fit in the devices I've been

researching, but they all use cement on the femoral side. I thought that

the cement was one of the long-term problems they were trying to get away

from, b/c loosening seemed to occur at the site of the cemented area.

Thanks for your input.

>

> Greg

>

May 3, 2004