Category Archives: HR for Women

Influence of Head Size and Sex on the Outcome of BHR 2010

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READ ORIGINAL STUDY BY CLICKING HERE

The Journal of Bone and Joint Surgery (American). 2010
Callum W. McBryde, MD, FRCS(Tr&Orth)1, Kanthan Theivendran, MRCS1, Andrew M.C.
Thomas, FRCS1, Ronan B.C. Treacy, FRCS(Tr&Orth)1 and Paul B. Pynsent, PhD1

1 Research and Teaching Centre, Royal Orthopaedic Hospital, Bristol Road
South, Northfield, Birmingham B31 2AP, United Kingdom. E-mail address for C.W.
McBryde: cwmcbryde@hotmail.com

Investigation performed at the Royal Orthopaedic Hospital, Birmingham, United
Kingdom

Background Hip resurfacing has gained popularity for the
treatment of youngand active patients who have arthritis. Recent
literature has demonstrated an increased rate of revision among
female patients as compared with male patients who have undergone hip
resurfacing. The aim of the present study was to identify any
differences in survival or functional outcome between male and female
patients with osteoarthritis who were managed with metal-on-metal hip resurfacing…

…Conclusions The present study demonstrates that although
female patients initially may appear …

I am a Female – Can I have a Hip Resurfacing by Patricia Dukes

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July 29, 2015

Read Patricia’s Full Story Here

As one of Dr Gross’ earlier patients, and a woman with small bones, I am saddened to hear the decision by S&N to prevent access of women to hip resurfacing.  The real truth of it IS and HAS ALWAYS BEEN the expertise of the surgeon that determines your outcome. I recall when S&N was so anxious to get their products out that they required very minimal standards for surgeons.

At one time (it may have changed) their requirement was simply to have observed (even by teleconference) two resurfacing surgeries and to have done one on a cadaver and then to have oversight by a company rep (non-physician) for the first few surgeries.

I knew many patients were in the first few (1-6) resurfacing their doctors performed, including a friend of mine that was #5 for his surgeon (mid-west) and has had trouble …

Dr. Rogerson Discusses Hip Resurfacing and Women

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Recent BHR news flash for females & others

Notice & Discussion of Recent BHR Data:

John Rogerson, M.D.  6/19/15

We recently (June 3, 2015) received notification from Smith & Nephew, Inc.,
the manufacturer and distributor of the Birmingham hip resurfacing prosthesis (BHR),
of a voluntary removal (NOT RECALL) from the market of a number
of the smaller prostheses sizes (see below Dr. letter about females).  Please
note, no further action is needed if you are not having any symptoms of pain or
decreased function following BHR hip resurfacing. If you are symptomatic, please
contact us to set up a follow-up appointment for further evaluation. 

Mid-term data analysis from the National Joint Registry of England & Wales
indicates that prosthetic head sizes below 46 mm in diameter and prostheses
implanted in females performed less well and exceeded current revision rate
benchmarks for total hip arthroplasty.  Male patients, in contrast, with head

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Dr. Voelker of Germany Discusses Hip Resurfacing for Women and Small Men

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Dear Patricia,

I would like to comment on Smith&Nephew’s BHR decision to exclude
females and smaller sizes than 48 mm.

The decision has been based on the renewed NICE criteria. I wouldn’t
say that I don’t want best outcomes for all of my patients. But if
you compare those criteria to other surgical outcomes it looks
extremely strict. I think it would be just consequent if the
collected data would have been collected the same way. The data
results could never be lets call it clean like they have been
collected. They are naturally influenced by so many things. For
example: Revision of resurfacing is so much easier (also the
decision is easier) than revision of THRs especially of cemented
stems, or let’s face the understandable poor results by some
surgeons especially in the past because of only few numbers of
performed resurfacings. That’s all in the statistics!

I question

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Dr. De Smet Discusses Hip Resurfacing for Women 2015

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FOR WOMEN THIS IS NOT AN ISSUE, BECAUSE THEY CAN GET CONSERVE PLUS WHICH HAS NOT THESE RESTRICTIONS, BECAUSE THERE IS A LARGER MARGIN AND COVERAGE!!!!

SO YOU CAN PUBLISH THIS ON YOUR WEBSITE ALSO WITH MY REMARKS!!!

THAT IS WHAT I WROTE IN MY BOOKLET ALREADY 6 YEARS AGO (you can find on my website)
WITH THE DIFFERENCES BETWEEN BHR AND CONSERVE.

Also
Correlation between inclination of the acetabular component and metal ion levels in metal-on-metal hip resurfacing replacement

I published this problem in 2008!!!

I DID TODAY 3 CONSERVES WITH LADIES OF US AND CANADA!  SIZES 42 AND 44!!!!!
KOEN
Koen De Smet, MD
AMC
Anca Medical Centre
Xavier De Cocklaan 68.1
9831 St Martens Latem Deurle
Belgium
+3292525903
Valle Giulia Roma Italy

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Dr. Bose of India Discusses Hip Resurfacing for Females and Small Men 2015

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June 30, 2015  – From a very philosophical standpoint hip arthroplasty is very unfair towards women!!!

Most men will have a socket size of 52 or over and therefore a 36 mms head can be used in all types of hip replacements. The 36 mms head is technically a “large head” and is a  good option having  serious resistance against dislocation. In addition men in general or not as lax / flexible as women and the risk of dislocation is significantly smaller. However the typical acetabular size in most women is  46 to 50. The small acetabular size in most women will dictate having a ridiculously small  28 mms or smaller  head  making it prone for dislocation.  Added to this is the flexibility / laxity in women which would accentuate the  problems imposing lot of restrictions in active
patients.

The decision by smith and nephew to withdraw 46 and below …

Hip Resurfacing for Women by Dr. Brooks

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Hi Pat

Yes, it is true.

Smith and Nephew was asked to respond to the long-known worse outcomes in females. This was precipitated by the UK’s National Institute of Clinical Excellence (NICE) raising their 10 year outcomes requirement from 90% where it been for years, to 95%.

Raising the bar left females and small sizes below the bar (along with a great many total hips as well, so expect more fall-out), and males well above the bar. If you remember, the UK registry, on which their regulators base decisions, had an average doctor’s resurfacing volume of just 4 per year, of which 3 would be expected to be men. So this decision, made for the safety of women, was based on the combined data in the UK of docs doing 1 per year.

Honestly, if I did one heart transplant a year, it wouldn’t do very well!

As a woman …

Dr. Pritchett Discusses Hip Resurfacing for Women and Small Men

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http://surfacehippy.info/10-year-results-highly-cross-linked-polyethlene-pritchett-2015.php Pat: Thanks for asking. In my view Smith & Nephew has acted responsibly. I have not been offering metal on metal resurfacing in the withdrawn smaller sizes. We have been offering just polyethylene in these sizes. I am attaching my abstract for an upcoming meeting. Yes, we use the implants shown on the Synovo Preserve site. We offer this to both men and women. We always use a cementless acetabular component and usually a cementless femoral component as well. Let me know the best way to reach patients. We are happy to talk with patients. I am concerned that patients might misinterpret the recent decision by Smith & Nephew as not supportive of resurfacing. As you know resurfacing is alive and well and works better than ever. We actually have more rather than less to offer patient. James Pritchett MD bonerecon@aol.com

Free Email Consultation
James W. Pritchett, M.D. – …

Dr. Gross Discusses Hip Resurfacing and Women 2015

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The continuing controversy – Thomas P. Gross MD. 7/4/2015 Young women who desire a more functional hip replacement were recently dealt a large blow  when the smaller sizes of the Birmingham Hip Resurfacing (BHR) device were withdrawn from the market by Smith Nephew Richards because the 10-year revision rate for women was higher than for men in most large registry analyses. (The major national registries are Australia, Combined Scandinavia, and Great Britain). Joint implant registries estimate an overall failure rate for different implants when used by the average surgeon in a country. Specialist surgeons can typically perform better than these data suggest. Hip resurfacing is a treatment for severe hip arthritis that results in a nearly normally functioning hip. Scientific studies  demonstrate that patients walk more normally in gait studies, and are more likely to be able to resume full impact sports if they have a hip resurfacing rather than

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