Re: what exactly is hip resurfacing? (sounds like roadwork!)

[Guest guest]

Go to www.grossortho.com That's Dr Gross's website and he has some marvelous

animation which will show you exactly what hip resurfacing is. Joyce (Dr

Gross, LHR, 2/2/04)

[Guest guest]

It is a form of hip replacement. The prosthesis differs from a

" conventional " total hip replacement (which you will see called a THR

on this list) in that the lower portion does not have a long stem that

is inserted into a cavity formed by reaming out the femur - rather it

has a ball that fits over the existing femoral ball (after some

reshaping by the surgeon). There are three big manufacturers with

more producing devices as the popularity (apparently) has increased.

The three most popular devices are the Birmingham Hip Resurfacing or

BHR, the Conserve Plus or C+, and the Cormet 2000 or C2K from

Corin.

The devices are (so far) made out of cobalt-chrome-steel and thus is

often referred to as a Metal-on-Metal (or M-o-M) device. Just to

confuse you, there are also THR devices that are M-o-M. I am not

aware of any resurfacing devices made of other materials but, if they

exist, other members will fill in the details.

A good place to start is to follow some of the links on

Brewster's web site - http://www.activejoints.com - is also the

founder/moderator of this list.

RC2K Dr. Gross 3/24/04

> Any info on resurfacing would be appreciated! Thanks

[Guest guest]

> It is a form of hip replacement. The prosthesis differs from a

> " conventional " total hip replacement (which you will see called a THR

> on this list) in that the lower portion does not have a long stem that

> is inserted into a cavity formed by reaming out the femur - rather it

> has a ball that fits over the existing femoral ball (after some

> reshaping by the surgeon). There are three big manufacturers with

> more producing devices as the popularity (apparently) has increased.

> The three most popular devices are the Birmingham Hip Resurfacing or

> BHR, the Conserve Plus or C+, and the Cormet 2000 or C2K from

> Corin.

>

> The devices are (so far) made out of cobalt-chrome-steel

Just a minor nit: the alloy is not " steel " . There's essentially no

iron in it whatsoever. It's ASTM F75 CoCrMo, which is mostly cobalt

(about 65%), 28% chromium, and 6% molybdenum. This material has been

used for various medical implants for decades. It's extremely hard and

very resistant to cracking, spalling, or corrosion.

>and thus is

> often referred to as a Metal-on-Metal (or M-o-M) device. Just to

> confuse you, there are also THR devices that are M-o-M. I am not

> aware of any resurfacing devices made of other materials but, if they

> exist, other members will fill in the details.

There has apparently been some very preliminary research into coating

the metal bearing surfaces with other, even harder substances (ceramic

and synthetic diamond). No devices using such coatings are available

yet, nor are they likely to be for several years.

>

> A good place to start is to follow some of the links on

> Brewster's web site - http://www.activejoints.com - is also the

> founder/moderator of this list.

Excellent advice.

Steve (bilateral C+ 4/20/04, Amstutz)

[Guest guest]

At 02:04 AM 4/30/2004 +0000, you wrote:

> >and thus is

> > often referred to as a Metal-on-Metal (or M-o-M) device. Just to

> > confuse you, there are also THR devices that are M-o-M. I am not

> > aware of any resurfacing devices made of other materials but, if they

> > exist, other members will fill in the details.

There are still a couple of other resurfacing devices out there, which can

just stay on their respective shelves as far as I'm concerned :-). One is

metal/poly and I think the other is ceramic/poly. It is the poly which

gave resurfacing such a bad name 20 years ago.

Cindy

C+ 5/25/01 and 6/28/01

[Guest guest]

Steve:

Thanks for the correction - I didn't realize it wasn't a steel alloy.

Now when I tell people it will sound more hi tech!

RC2K Dr. Gross 3/24/04

> > It is a form of hip replacement. The prosthesis differs from a

> > " conventional " total hip replacement (which you will see called a THR

> > on this list) in that the lower portion does not have a long stem that

> > is inserted into a cavity formed by reaming out the femur - rather it

> > has a ball that fits over the existing femoral ball (after some

> > reshaping by the surgeon). There are three big manufacturers with

> > more producing devices as the popularity (apparently) has increased.

> > The three most popular devices are the Birmingham Hip Resurfacing or

> > BHR, the Conserve Plus or C+, and the Cormet 2000 or C2K from

> > Corin.

> >

> > The devices are (so far) made out of cobalt-chrome-steel

>

> Just a minor nit: the alloy is not " steel " . There's essentially no

> iron in it whatsoever. It's ASTM F75 CoCrMo, which is mostly cobalt

> (about 65%), 28% chromium, and 6% molybdenum. This material has been

> used for various medical implants for decades. It's extremely hard and

> very resistant to cracking, spalling, or corrosion.

>

> >and thus is

> > often referred to as a Metal-on-Metal (or M-o-M) device. Just to

> > confuse you, there are also THR devices that are M-o-M. I am not

> > aware of any resurfacing devices made of other materials but, if they

> > exist, other members will fill in the details.

>

> There has apparently been some very preliminary research into coating

> the metal bearing surfaces with other, even harder substances (ceramic

> and synthetic diamond). No devices using such coatings are available

> yet, nor are they likely to be for several years.

>

> >

> > A good place to start is to follow some of the links on

> > Brewster's web site - http://www.activejoints.com - is also the

> > founder/moderator of this list.

>

> Excellent advice.

>

> Steve (bilateral C+ 4/20/04, Amstutz)

[Guest guest]

,

Several months before my re-surfs my co-workers held a lunch for me.

My wife was talking to one of my female co-workers about an unrelated

event that would be several months after my operation. My wife,

without mentioning the operation, said " Well, I'll see about that

after Ed gets his new Stainless Steel balls. " The jaws of the 15

person mixed crowd dropped. I managed to interject " You might want to

clarify that and besides they're Cobalt Chrome! " before the place

descended into unrestrained laughter.

Ed

C+ Bilat Dr. Mont 2/23-3/01/04

> > > It is a form of hip replacement. The prosthesis differs from a

> > > " conventional " total hip replacement (which you will see called

a THR

> > > on this list) in that the lower portion does not have a long

stem that

> > > is inserted into a cavity formed by reaming out the femur -

rather it

> > > has a ball that fits over the existing femoral ball (after some

> > > reshaping by the surgeon). There are three big manufacturers

with

> > > more producing devices as the popularity (apparently) has

increased.

> > > The three most popular devices are the Birmingham Hip

Resurfacing or

> > > BHR, the Conserve Plus or C+, and the Cormet 2000 or C2K

from

> > > Corin.

> > >

> > > The devices are (so far) made out of cobalt-chrome-steel

> >

> > Just a minor nit: the alloy is not " steel " . There's essentially no

> > iron in it whatsoever. It's ASTM F75 CoCrMo, which is mostly

cobalt

> > (about 65%), 28% chromium, and 6% molybdenum. This material has

been

> > used for various medical implants for decades. It's extremely

hard and

> > very resistant to cracking, spalling, or corrosion.

> >

> > >and thus is

> > > often referred to as a Metal-on-Metal (or M-o-M) device. Just

to

> > > confuse you, there are also THR devices that are M-o-M. I am

not

> > > aware of any resurfacing devices made of other materials but,

if they

> > > exist, other members will fill in the details.

> >

> > There has apparently been some very preliminary research into

coating

> > the metal bearing surfaces with other, even harder substances

(ceramic

> > and synthetic diamond). No devices using such coatings are

available

> > yet, nor are they likely to be for several years.

> >

> > >

> > > A good place to start is to follow some of the links on

> > > Brewster's web site - http://www.activejoints.com - is

also the

> > > founder/moderator of this list.

> >

> > Excellent advice.

> >

> > Steve (bilateral C+ 4/20/04, Amstutz)

[Guest guest]

Ed:

Thanks for the major chuckle!

> > > > It is a form of hip replacement. The prosthesis differs from a

> > > > " conventional " total hip replacement (which you will see called

> a THR

> > > > on this list) in that the lower portion does not have a long

> stem that

> > > > is inserted into a cavity formed by reaming out the femur -

> rather it

> > > > has a ball that fits over the existing femoral ball (after some

> > > > reshaping by the surgeon). There are three big manufacturers

> with

> > > > more producing devices as the popularity (apparently) has

> increased.

> > > > The three most popular devices are the Birmingham Hip

> Resurfacing or

> > > > BHR, the Conserve Plus or C+, and the Cormet 2000 or C2K

> from

> > > > Corin.

> > > >

> > > > The devices are (so far) made out of cobalt-chrome-steel

> > >

> > > Just a minor nit: the alloy is not " steel " . There's essentially no

> > > iron in it whatsoever. It's ASTM F75 CoCrMo, which is mostly

> cobalt

> > > (about 65%), 28% chromium, and 6% molybdenum. This material has

> been

> > > used for various medical implants for decades. It's extremely

> hard and

> > > very resistant to cracking, spalling, or corrosion.

> > >

> > > >and thus is

> > > > often referred to as a Metal-on-Metal (or M-o-M) device. Just

> to

> > > > confuse you, there are also THR devices that are M-o-M. I am

> not

> > > > aware of any resurfacing devices made of other materials but,

> if they

> > > > exist, other members will fill in the details.

> > >

> > > There has apparently been some very preliminary research into

> coating

> > > the metal bearing surfaces with other, even harder substances

> (ceramic

> > > and synthetic diamond). No devices using such coatings are

> available

> > > yet, nor are they likely to be for several years.

> > >

> > > >

> > > > A good place to start is to follow some of the links on

> > > > Brewster's web site - http://www.activejoints.com - is

> also the

> > > > founder/moderator of this list.

> > >

> > > Excellent advice.

> > >

> > > Steve (bilateral C+ 4/20/04, Amstutz)

[Guest guest]

Ed:

Thanks for the major chuckle!

> > > > It is a form of hip replacement. The prosthesis differs from a

> > > > " conventional " total hip replacement (which you will see called

> a THR

> > > > on this list) in that the lower portion does not have a long

> stem that

> > > > is inserted into a cavity formed by reaming out the femur -

> rather it

> > > > has a ball that fits over the existing femoral ball (after some

> > > > reshaping by the surgeon). There are three big manufacturers

> with

> > > > more producing devices as the popularity (apparently) has

> increased.

> > > > The three most popular devices are the Birmingham Hip

> Resurfacing or

> > > > BHR, the Conserve Plus or C+, and the Cormet 2000 or C2K

> from

> > > > Corin.

> > > >

> > > > The devices are (so far) made out of cobalt-chrome-steel

> > >

> > > Just a minor nit: the alloy is not " steel " . There's essentially no

> > > iron in it whatsoever. It's ASTM F75 CoCrMo, which is mostly

> cobalt

> > > (about 65%), 28% chromium, and 6% molybdenum. This material has

> been

> > > used for various medical implants for decades. It's extremely

> hard and

> > > very resistant to cracking, spalling, or corrosion.

> > >

> > > >and thus is

> > > > often referred to as a Metal-on-Metal (or M-o-M) device. Just

> to

> > > > confuse you, there are also THR devices that are M-o-M. I am

> not

> > > > aware of any resurfacing devices made of other materials but,

> if they

> > > > exist, other members will fill in the details.

> > >

> > > There has apparently been some very preliminary research into

> coating

> > > the metal bearing surfaces with other, even harder substances

> (ceramic

> > > and synthetic diamond). No devices using such coatings are

> available

> > > yet, nor are they likely to be for several years.

> > >

> > > >

> > > > A good place to start is to follow some of the links on

> > > > Brewster's web site - http://www.activejoints.com - is

> also the

> > > > founder/moderator of this list.

> > >

> > > Excellent advice.

> > >

> > > Steve (bilateral C+ 4/20/04, Amstutz)

[Guest guest]

>

> > >and thus is

> > > often referred to as a Metal-on-Metal (or M-o-M) device. Just to

> > > confuse you, there are also THR devices that are M-o-M. I am not

> > > aware of any resurfacing devices made of other materials but, if

they

> > > exist, other members will fill in the details.

> There are still a couple of other resurfacing devices out there,

which can

> just stay on their respective shelves as far as I'm concerned :-).

One is

> metal/poly and I think the other is ceramic/poly. It is the poly which

> gave resurfacing such a bad name 20 years ago.

Well, not quite. There's a new metal/poly resurfacing implant that

uses crosslinked UHMWPE (ultra-high molecular weight polyethylene).

The cross-linked poly is considerable tougher than the old poly,

although it's obviously not as durable as MoM. It also doesn't permit

quite as large a ball size as MoM (I think they top out at ~40mm -

still a lot better than the 28mm that's typical of a metal/poly

conventional THR). The lab test data suggest that these ought to be

4-10 times as durable as conventional poly THRs. This is still a lot

less than the 20-100 times reported by lab simulations of MoM

resurfacing, but it still may be a viable alternative in individuals

who have problems with metal debris.

Since I have some renal issues, Dr. Amstutz offered me these as an

alternative if I was uncomfortable with the whole metal ion thing, but

(after perusing the available literature) I declined.

Steve (bilateral C+ 4/20/04, Amstutz)

[Guest guest]

>

> > >and thus is

> > > often referred to as a Metal-on-Metal (or M-o-M) device. Just to

> > > confuse you, there are also THR devices that are M-o-M. I am not

> > > aware of any resurfacing devices made of other materials but, if

they

> > > exist, other members will fill in the details.

> There are still a couple of other resurfacing devices out there,

which can

> just stay on their respective shelves as far as I'm concerned :-).

One is

> metal/poly and I think the other is ceramic/poly. It is the poly which

> gave resurfacing such a bad name 20 years ago.

Well, not quite. There's a new metal/poly resurfacing implant that

uses crosslinked UHMWPE (ultra-high molecular weight polyethylene).

The cross-linked poly is considerable tougher than the old poly,

although it's obviously not as durable as MoM. It also doesn't permit

quite as large a ball size as MoM (I think they top out at ~40mm -

still a lot better than the 28mm that's typical of a metal/poly

conventional THR). The lab test data suggest that these ought to be

4-10 times as durable as conventional poly THRs. This is still a lot

less than the 20-100 times reported by lab simulations of MoM

resurfacing, but it still may be a viable alternative in individuals

who have problems with metal debris.

Since I have some renal issues, Dr. Amstutz offered me these as an

alternative if I was uncomfortable with the whole metal ion thing, but

(after perusing the available literature) I declined.

Steve (bilateral C+ 4/20/04, Amstutz)

[Guest guest]

>

> > >and thus is

> > > often referred to as a Metal-on-Metal (or M-o-M) device. Just to

> > > confuse you, there are also THR devices that are M-o-M. I am not

> > > aware of any resurfacing devices made of other materials but, if

they

> > > exist, other members will fill in the details.

> There are still a couple of other resurfacing devices out there,

which can

> just stay on their respective shelves as far as I'm concerned :-).

One is

> metal/poly and I think the other is ceramic/poly. It is the poly which

> gave resurfacing such a bad name 20 years ago.

Well, not quite. There's a new metal/poly resurfacing implant that

uses crosslinked UHMWPE (ultra-high molecular weight polyethylene).

The cross-linked poly is considerable tougher than the old poly,

although it's obviously not as durable as MoM. It also doesn't permit

quite as large a ball size as MoM (I think they top out at ~40mm -

still a lot better than the 28mm that's typical of a metal/poly

conventional THR). The lab test data suggest that these ought to be

4-10 times as durable as conventional poly THRs. This is still a lot

less than the 20-100 times reported by lab simulations of MoM

resurfacing, but it still may be a viable alternative in individuals

who have problems with metal debris.

Since I have some renal issues, Dr. Amstutz offered me these as an

alternative if I was uncomfortable with the whole metal ion thing, but

(after perusing the available literature) I declined.

Steve (bilateral C+ 4/20/04, Amstutz)