Finsbury adept cementless femoral head

[Dannywayoflife]

While trying to research cement vs no cement I stumbled across a product made by finsbury has anyone else herd anything about this implant or has anyone got one "installed?"

[einreb]

That looks pretty cool (I don't know if cool translates to 'good' )

http://www.finsbury.org/documents/ADEPT-Technical-Bulletin12.pdf

the shorter stem is interesting too.  I wonder what the rational is for the stem length in most current devices?

-Bernie

[Dannywayoflife]

Yeah It does seem interesting I don't know but I think the shorter stem may make revision easyer?
The bone fixation beads look like a good way of providing a bone ingrowth surface.

[toby]

I knew about it shortly before my HR a year ago (Finsbury Adept-cemented) and during my Finsbury research saw a Bulletin and became aware that they were involved in trials for this product. Spoke with my surgeon just prior to my op-as I was very interested but he wasn't one of the trial surgeons.
It would be very interesting to find out the state of play re-research findings, developments, planned use etc.
Toby

[Dannywayoflife]

I may try and get some info from finsbury about it. I have seen some data from finsbury tho about wear of there other HR devices and it seemed to reckon on a life span of between 5-10 years which worried me. I Kay have read it wrong tho.

[Lopsided]

Coming from London, I never fancied a device call Birmingham, but a device called Finsbury does appeal. Did not know they did an uncemented version, or I might have requested it.

[toby]

Danny you wrote-
'I have seen some data from finsbury tho about wear of there other HR devices and it seemed to reckon on a life span of between 5-10 years which worried me'.
I've read a lot of info from Finsbury and don't ever recall this-I'm sure that you may have read-please direct me to the source.
Thanks
Toby
ps lopsided-As a fellow Londoner I appreciate the wit-how's KDS's premier patient doing?

[Dannywayoflife]

Danny you wrote-
'I have seen some data from finsbury tho about wear of there other HR devices and it seemed to reckon on a life span of between 5-10 years which worried me'.
I've read a lot of info from Finsbury and don't ever recall this-I'm sure that you may have read-please direct me to the source.
Thanks
Toby
ps lopsided-As a fellow Londoner I appreciate the wit-how's KDS's premier patient doing?

Simulator studies stop during the steady-state wear phase and often only extend to five million cycles which, depending on the patient's activity levels, only represents a lifespan of one to five years. The ADEPTŪ technical rationale is entirely based on clinical history dating back over 25 years.
This comes from the finsbury web site just look under the adept resurfacing section.
Hope this helps Danny

[Dannywayoflife]

Today i called both finsbury and dupuy to ask about some info about this device but both refused to give me any! so i have emailed the surgeon who did my arthroscopy in october to ask him to make enquireries for me. Ill keep you all posted if i manage to get any info about the device.
Danny

[einreb]

Simulator studies stop during the steady-state wear phase and often only extend to five million cycles which, depending on the patient's activity levels, only represents a lifespan of one to five years. The ADEPTŪ technical rationale is entirely based on clinical history dating back over 25 years.
This comes from the finsbury web site just look under the adept resurfacing section.
Hope this helps Danny

I've wondered about that.  Numbers along the lines of .2 mm^3 of wear per million cycles steady state is tossed around for modern metal on metal large ball.  Figure 3 million steps per year over the course of 20 years.  That's 12 cubic millimeters. That is not an insignificant amount when talking about the tolerances required.

[Dannywayoflife]

Simulator studies stop during the steady-state wear phase and often only extend to five million cycles which, depending on the patient's activity levels, only represents a lifespan of one to five years. The ADEPTŪ technical rationale is entirely based on clinical history dating back over 25 years.
This comes from the finsbury web site just look under the adept resurfacing section.
Hope this helps Danny

I've wondered about that.  Numbers along the lines of .2 mm^3 of wear per million cycles steady state is tossed around for modern metal on metal large ball.  Figure 3 million steps per year over the course of 20 years.  That's 12 cubic millimeters. That is not an insignificant amount when talking about the tolerances required.

can you put the figures into laymans terms? Was i right t be concerned about the potental life span of a resurfaceing?

[einreb]

can you put the figures into laymans terms? Was i right t be concerned about the potental life span of a resurfaceing?

Danny,

Please don't read anything into my 'concerns'. I am actually a mechanical engineer, but that in no way means that I know what I'm talking about with this stuff.  The point is that these devices do 'wear', but since all the long term stuff is pure simulation... we don't know how they wear in the body.  My calculation is simple and may be completely off base.  It says that after 20 years, the device will have lost a little over a centimeter square and 1 millimeter high of metal.  Does it wear evenly and keep the required tolerances so that the bearing continues to 'float' on the lubricating joint fluid? If it doesnt, then it will wear faster, if it does... then it may last another 20 years   I don't know.

I'm 40 years old.  I used to run marathons.  I will not run them with my resurfaced hip.  I'm going to run on it to promote good bone strength, but I would like it to last a long time.  I would love to get 25 years out of this thing.  Hopefully then is a current bearing and stem that will then have a 25 year history with active patients.

The fact that the BHR is 14+ years old and seems to be holding up really bodes well for the longer term.  There are stories of metal on metal devices lasting much longer than that.

[Dannywayoflife]

many thanks for your reply. I am only 28 and fear that i will require a RS before im 30. I have been an active athlete for the last 15 years mainly martial arts but also a fair amount of running too! I would like to get back to some form of training post op but realise i may well have to slightly ajust my normal behaviour. I am mainly interested in this device because of the factits un cemented as that seems to be the future.

[toby]

Danny,
Yes I had read this in the past. But I read it very differently. I thought that Finsbury were suggesting that other newer manufacturers/their competitors (like at the time the De-puy ASR) were using simulator studies with an insufficient number of cycles which would only equate to the the first1-5 years. But Finsbury instead were using their 25 years of clinical studies and HR experience in the development of  and their confidence in the Adept. Remember, Finsbury worked on early MOM designs and with McMinn on the BHR from the beginning. The Adept is very similar to the BHR. So I think they're being critical of their inexperienced competitors whose predictions can only be based on simulator studies.
In relation to wear-see the McMinn lectures-he talks about minute based on all his extensive data from the last 15-20 years and predicts(as does my surgeon) that these devices will last a life time if perfectly placed.
Regards
Toby

[Tin Soldier]

I think I owe Dannyway a response on my post about the longevity of the MOM devices.  I think it was in another thread but can't find it. 

My surgeon, Jim Prichett in Seattle, WA, who has followed MOM and earlier poly on metal types, since the 80's, feels that at my age, 40, I should not assume that I will have to get a revision or go to THR within the next 40 years.  Granted, we have very limited data on 40 years, actually, I think there are zero data for 40 years.  He's not saying outright that the BHR that I have will last 40 years, but he's also not saying that there is any indication from 10 year case studies for Wright, S&N, and others, that these things will give out at 15 yrs, 20 yrs, or later.

I felt a little backed into a corner with regards to my decision on HR.  My boys are going to be out of the house in 5 years.  I made the choice to get my life back before that, even if I had to get a revision or a THR in 15 years.  I was under the assumption that the MOM HRs will last 10 to 15 years and I was ok with that.  I'm a scientist and I too would like to see real numbers.  At 28 I can totally understand your concern on longevity.       

BTW - the American Academy of Orthopaedic Surgeons Annual Conference just happened in San Diego.  I just looked at the program and there were a number of papers/presentations on MOM HR.  You might check out the program (300 pages ) and see if there was anything on this topic.

[Dannywayoflife]

toby&tin soldier,
                      thanks for the replys guys i really appreciate it. Im constantly looking for more and more research to read they do say knowledge is power!

[Dannywayoflife]

To be honest if i got 20 years out of a RS i would be extatic!

[Lopsided]

My dad had both of his hips done with the old style plastic on chipboard small ball THRs nearly twenty years ago, and he is still doing well. True, he is not as active as younger people. So I would expect, and hope as I have got one, that a large ball high tech modern alloy metal on high tech modern alloy metal resurfacing should last quite a lot longer.

D.

[moe]

The McMinn Centre website has lots of good info and history of resurfacing although I haven't looked at it recently.

moe

[Dannywayoflife]

I'm still trying to find out some info about this device I've email my arthroscopy surgeon asking him to request some info for me and I'll update you all if and when I get any further info. If anyone else knows anymore about it though please do share
Danny out.