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.