Prof. Dr. Eugen Winter Interview
Prof. Dr. med. Eugen Winter – BHR trained McMinn
UK 2005
500 BHR Hip Resurfacings to date***
18 BMHR to date***
Klinikum Friedrichshafen
Clinic for Orthopedic and Trauma Surgery
Röntgen Str. 2
88048 Friedrichshafen
Germany
Phone: (0049-7541) 961311
Fax: (0049-7541) 961314
E-mail:
e.Winter@klinikum-fn.de
Website:
www.klinikum-fn.de
When did you start
doing hip resurfacing?
My first BHR: 21st
February 2005.
Where did you train?
18th
February 2005: Faensen/Berlin, 24th August 2006:
McMinn/Birmingham, 27 October 2006 De Smet, Gent.
Why were you interested in hip resurfacing?
Good option for
young patients, preservation of bone, good revision
possible, resurfacing anatomically and biomechanically more
similar to the natural hip than THR, less dislocation risc,
almost no risk of leg length discrepancy, less blood loss
than THR
What hip resurfacing device do you
use?
BHR (only)
What surgical approach do you
use?
Why do you prefer that approach? Posterior approach.
Gives a very good exposure for good component positioning,
little trauma to the soft tissue, muscle sparing approach.
Do you have a cut off age for resurfacing patients or do you go on a case by case basis? In my 500 BHR Cases the average age was 54 years. I don’t have a cut off age. Each patient has to be evaluated individually. Deciding factors for me are the "biological" age an the bone quality.
How do you feel about cementless devices?
Do you prefer
cemented and why? I only use the classical BHR with the
cemented head since this device has the best long term
results.
What size incision do you normally
give your patients for resurfacing?
12-14 cm. I tried in
some cases mini incision (about 8 cm), but I could not get a
good enough exposure of the acetabulum and the femur head.
Does the length of incision influence the rehabilitation?
From my experience: no (not in hip and not in knee arthroplasty).
Do you preserve the hip
capsule during your hip resurfacing surgeries?
Yes, if there
is no contracture.
What is your typical recovery time after
resurfacing?
6 weeks
What is your typical
rehab protocol?
Full weigth bearing, crutches for 6 weeks,
90 degree restriction for 6 weeks, heparin s.c. (Clexane 40)
for 6 weeks.
What type of anesthesia do you
use general or epidural or?
In almost all cases: general
anesthesia.
How long do you feel it takes for
the bone to be fully healed, grow into the prosthesis?
At
least 12 weeks.
What is the recommended time
you tell your patients before they can start to run again/do
impact sports?
12 weeks.
Why is hip resurfacing better than a THR-for the proper candidate? Less bone resection. Reduced survival rate of THR in young patients, resurfacing is anatomically and biomechanically more similar to the natural hip than THR, normal femoral loading, proprioceptive feedback not destroyed, less dislocation risk, almost no risk of leg length discrepancy, less blood loss compared to THR.
What other
important information about hip resurfacing do you want to
share with possible patients?
In Germany a lot of surgeons
gained bad experience with the "Wagner-Cup" in the 1970th.
Until today quite a lot of German surgeons have
inappropriate prejudices concerning the modern hip
resurfacing. This is what I want to change.
Do you use the BMHR – Birmingham
Mid Head Resection
I began using the BHMR in September
2008. Meanwhile 21 patients got the BMHR device. All
patients are fine, there were no complications so far.