Yet More On The Uncemented Debate

[Lopsided]

Six months after being Dr. De Smet's first uncemented C+, as to his intentions to continue with uncemented he said:

• He will start doing them this week.
• A colleague of his (don't know who) has done one hundred uncemented with good results.
• He will do uncemented in all cases which are good for it.
• It might be expected to be the standard form of resurfacing once it has fully proven results.

D.

[John C]

Thanks for the update. If you are in contact with him again, it would be interesting to hear if he will be using only the C+, or if he would also be using the Biomet. Since he is going cementless, it would be interesting to hear his thoughts in comparing these two brands.

[einreb]

De Smet seems pretty committed to the C+.  He wrote an interesting comparison paper on it vs. the BHR.  Other than what he considered to be improved instrumentation and sizing options, I think that the blood test/metal levels indicated to him that the C+ was 'wearing' better.

[Lopsided]

Thanks for the update. If you are in contact with him again, it would be interesting to hear if he will be using only the C+, or if he would also be using the Biomet. Since he is going cementless, it would be interesting to hear his thoughts in comparing these two brands.

John, I think he prefers to use the C+, and only does other devices by request.

D.

[jackmac32]

Very interesting.  I had a cemented left hip BHR done by Dr. Su in October 2009 and couldn't be happier with the Doctor, Hospital, and the results.   My right hip will probably need help in 1-2 years.  Wondering if things are shifting to uncemented and if veteran Doctors like Su will now be offering it as an option.

[sharonToews]

Hi:
I had the cemented resurfacing done by Dr.DeSmet...it has almost been 3 years and I still see improvement.   Sharon

[hernanu]

That's excellent, Sharon - always good to hear reports down the line for us rookies.

[Dannywayoflife]

Looking back at one point I was convinced that cement was the devil and cemenless was the way forward. A year down the line and now I feel somewhat different. Having now seen sectioned bhr's that have been recovered I now know why Derrick Mcminn has yet to have a single femoral loosening since going to cemented. Yes I aggree that cementless can work fantastically however the cementless devices out there now are significantly worse in the joint registrys than the bhr. Also don't forget that the way the cement is used in a bhr is different to a THR and from what I've read all the cemented HR devices.
Cemented in a THR is definatly not as durable as cementless but in a HR the load is transferred in a totally different way.
Until it's proven otherwise then I believe the best device on the Market is the bhr.

[einreb]

cementless devices out there now are significantly worse in the joint registrys than the bhr.

where is that data?  Just curious since I've never seen uncemented devices broken out in a registry.  DeSmet hasn't been doing them that long and I don't think Dr Gross' series are part of a registry.

[obxpelican]

Those registries don't use US numbers, Dr. Gross numbers are much much higher in success rates.

Again, depends on quality of the surgeon.  I would love to see other doctors doing the biomet to see what kind of success rates they would have.


Chuck

[Dannywayoflife]

There part of the Australian register. Your correct tha Dr Gross's results are not in a register as the US has yet to set one up. If you watch the Mcminn video where he discusses cemented and uncemented he shows the results from the Australian register for several un cemented devices I think it included the eska bionik,the biomet recap, and possibly the C+

[DavidJ]

What is C+ and is different then a BHR?

[Dannywayoflife]

The C+ is a device made by wright I believe. It is quite different in design from the bhr, in several ways including metallurgy and cement mantle in the cemented version. The C+ has a mantle where as the bhr is line to line.