Surgeon Thomas Vail likes the results he’s
seeing with his resurfacing patients. Two years
after the surgery, he finds resurfacing patients
do have slightly more range of motion in their
movements than his older patients who’ve
undergone total hip replacement.
Dr. BeauleAccording to Beaulé, the following patient
selection factors can favorably impact modern
resurfacing outcomes:no large femoral head cyst;
younger than 65 years old; and
no prior hip surgery.
“My current ideal indications for hip
resurfacing are patients age less than 60 years,
risk index less than or equal to 3,” he said.
The risk index – surface arthroplasty risk index
(SARI) – is a tool for
Half of the stitches or staples are normally
removed after 14 days. The remaining half is
removed after 16 days. Depending on the
individual patient, one can decide to remove the
staples later on. Staples are removed with a
In case of an intracutaneous suture, one only
has to cut off one end of the suture. It is not
the purpose to remove the complete
Psoas tendinitis is an important reason for groin
pain in resurfacing surgery.
This is peculiar to resurfacing as the cup for
resurfacing is a very large profile ie half a sphere.
Nearly all THR cups are only portions ( arc) of a
Hence if the antero-posterior orientation i.e., version
of the cup is
There has been some recent confusion about
different types of
surgical anesthesia. This is a summary of information which I
is helpful. Orthopedic and other surgeons generally work with an
anesthesiologist, a specialist in Perioperative Medicine. This
care of a patient prior to, during and after surgery. This
evaluating and preparing a patient to undergo
The anterior vs. posterior debate isn’t going to be resolved
by one study of electrode blood flow. Most surgeons would
agree that blood flow to the femoral head (most of which
comes backwards via the femoral neck) is theoretically
better preserved through an anterior approach. Much of this
info comes from the work of Ganz, who did a lot of cadaver
dissection to prove this.
Does the length of incision influence the rehabilitation?
No! A bigger incision does not mean that there will be more
damage to the muscular structures. On the contrary, if you
need a bigger incision to get better exposure, the placement
of the implant can be done more precisely. Even with an
incision of 30 cm you are able to walk well after 24 hours.
I advise patients not to return to
impact sport for 1 year after surgery. For those
patients who want to road run, I get them
running on a treadmill at 10 months post-op and
they resume road running at 12 months post-op.
My unit published on activity level after
resurfacing some years ago in a group of
patients who followed those rules. In young men
with a single
How old is the BHR / Conserve Plus (C+) procedure?
BHR procedure is developed in 1996/97. The first
metal-on-metal resurfacing is from Feb. 1991. The resurfacing is
already 40 years old, metal-on-metal is 40 years old (the oldest
dates from 1938!). Both ideas were put together by Mr. McMinn in
1989. The Conserve Plus design was introduced by Dr. Amstutz in