AGH Center for Joint Surgery Offers Alternative to Total Hip Replacement

03-02-2007

Birmingham Hip Resurfacing available for the first time on Maryland’s Eastern Shore

Previously individuals suffering from severe hip pain due to arthritis or injury had only one surgery option: total hip replacement. This procedure has its drawbacks for the younger set who face a second, possibly less successful, total replacement surgery when the first wears out – or years of pain waiting to have the surgery to ensure that it lasts for the rest of their lives. For some individuals on the Eastern Shore, there is now another option.

Birmingham Hip Resurfacing, offered by orthopedic surgeon Thomas Beck, D.O., in Atlantic General Hospital’s Center for Joint Surgery, is a bone-conserving technique that allows a patient to keep the femoral ball – something that is removed during a total hip replacement. Instead, a metal implant is placed on the end of the ball, which then fits inside the metal-lined hip socket. This hardware is more like a cap on a tooth than a traditional hip implant.

Similar to a total hip replacement, the procedure eliminates the pain caused by the femoral bone rubbing against the hip socket when the protective cartilage between the bones has been worn away. What is different is the durability and range of motion offered with the resurfacing.

The Birmingham implant is made from cobalt chrome, a tough metal that can better handle the everyday wear and tear produced by a younger, more active patient. Additionally, it does not require a plastic liner to separate the metal surfaces of the ball implant and the socket like that used with a total hip replacement. This liner can slowly break down over time, resulting in irritation in the joint and ultimate failure of the hip replacement.

The Birmingham implant is also larger in diameter than that used in total hip replacement. Often closer is size to the patient’s original femoral ball, it reduces the risk of dislocation and allows further range of motion as the ball rotates in the socket.

According to Dr. Beck, who completed a fellowship in hip and knee reconstruction and has more than eight years of experience in joint replacement, recipients of the Birmingham Hip Resurfacing can resume their physical activities after a three-month recovery period.

Although they are discouraged from running on the hip for a year, recipients can resume pretty much any high impact physical activity. Marathon runners, Olympic athletes, and professional cyclists have had the procedure; this type of physical activity would never be advised after a total hip replacement.

“If Birmingham Hip Resurfacing had been around in the early 90s, Bo Jackson probably would have played baseball longer,” Beck said.

Roy Cragway, M.D., a primary care physician who has worked at Atlantic General Hospital and Health System since 1994, isn’t interested in running a marathon or playing professional baseball. He would be happy with walking pain free and being able to tie his left shoe, which has become impossible.

Cragway developed arthritis in his left hip a year and a half ago and the pain became so intense that he was contemplating a total hip replacement, even though he’s only 52 years old. Having put serious thought into replacement surgery since October 2006, he jumped at the chance to have the Birmingham procedure when Dr. Beck suggested it in early February of this year.

“It was affecting my disposition, and I had to rely on pain medication,” said Cragway. “It was affecting everything in my life.”

Less than three weeks later, Cragway was a patient in Atlantic General’s Center for Joint Surgery and became the first recipient of the Birmingham Hip Resurfacing on the Shore.

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Unfortunately, not everyone experiencing hip joint pain is a viable candidate for the Birmingham procedure. For the resurfacing to be successful, the bone needs to be very strong. Bone density examinations are part of the screening process, and many post-menopausal women are eliminated due to the effects of osteoporosis.

Roughly 70 percent of those who qualify will be men under the age of 60. Other likely candidates include men above the age of 60 who are particularly active and pre-menopausal women who have experienced the effects of osteonecrosis or developmental dysplasia.

It is not yet known just how long the Birmingham Hip Resurfacing will keep a patient active and pain-free. But, it will last at least as long as total hip replacement, with an added benefit: the intact original bone gives more for a surgeon to work with if a future total hip replacement is necessary.
As might be expected with traditional surgery, Cragway experienced almost immediate relief from joint pain after his surgery.

“I have a lot of muscle and tissue that needs to mend, but I’m getting there,” said Cragway less than a week after his surgery. “The kind of pain I had before the surgery was gone the next day.”
“Now, I’m sure I’ll set off every detector in the airport, but it’s worth it.”

For more information about Birmingham Hip Resurfacing, contact Karen Christmas at Atlantic General Hospital’s Center for Joint Surgery at 410-641-9131. Dr. Beck is one of a select few surgeons approached by Smith & Nephew, the maker of the Birmingham Hip implant, to perform this procedure – just 400 surgeons are trained in the United States. All cases are monitored by the FDA, which recently approved the Birmingham Hip Resurfacing for use in this country.

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