BHR and Other Options – Derek McMinn Lecture2013
Published on July 2, 2013
Derek McMinn presents a talk on the Birmingham Hip
Resurfacing (BHR) and the alternative options for hip joint replacement
surgery. Starting with the development of the BHR, Mr McMinn goes on to
discuss survivorship rates and revisions, cancer, metal ions, the DePuy ASR
disaster, Delta Ceramic and new development Polymix. The presentation is
dedicated to the late Vicky Marlow, a fantastic patient advocate and voice
of support in the hip resurfacing community.
In this lecture, Mr. McMinn talks about the development of the metal-on-metal
hip resurfacing implants he has designed, looking at survival rates and
pilot studies. Press-fit, cemented and un-cemented implants were all tested
and the best outcome was a single heat-treated hybrid un-cemented cup and a
cemented femoral component. The Birmingham Hip Resurfacing (BHR) was
developed by a company formed by Mr McMinn and Ronan Treacy after
relationships with earlier hip resurfacing manufacturers didn’t work out
Mr. McMinn goes through the outcomes of the first 1000 BHR patients, whose
operations date from July 1997 to August 2000. The results are broken down
and compared between gender and age, covering areas such as primary
diagnoses, implant survival probability, implant head size, failure rates
and revision surgery.
Derek McMinn makes three key statements during the lecture, hip resurfacing
has better function compared to Total Hip Replacement (THR), BHR in young
people has lower revision rate than THR and BHR in men has a lower death
rate compared to THR. Mr McMinn discusses the research into these areas by
analysing various studies and results. Most notable are the findings of a
study into cancer rates in metal-on-metal patients compared to alternative
bearings.
Back in 2005, Mr. McMinn warned DePuy Johnson & Johnson about the ASR device
but was a lone voice. In this talk, he questions why the ASR was so much
worse than the BHR and the effect that the ASR recall has had. Click here to
watch Mr. McMinn warning DePuy at Northern Lights Debate, Helsinki.
An alternative resurfacing implant for patients with sensitivity to metals
is a ceramic-on-ceramic resurfacing. Mr. McMinn looks at his own unsuccessful
series of five ceramic-on-ceramic hip resurfacings and looks at the widely
used the pink Delta Motion THR ceramic device made by Ceramtec. Ceramic
contains elements of metal and Mr. McMinn raises some concern over the
potentially harmful type of Chromium produced in the metal debris of a Delta
Ceramic in situ.
Looking towards the future, Mr. McMinn describes how highly cross-linked
polyethylene is potentially the way forward. Polymix is a hybrid cup made of
conventional polyethylene and highly cross-linked polyethylene in the
wear-zone.
For more information on Derek McMinn and Hip Resurfacing/Replacement options
please visit
http://www.mcminncentre.co.uk/