Dr. Pete Rose Joint Replacement. Total = Ball + Socket.
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Transcript of Dr. Pete Rose Joint Replacement. Total = Ball + Socket.
Dr. Pete Rose
Joint Replacement
Joint Replacement
Total = Ball + Socket
Ball/Socket Replacement
CHARNLEY THA: 30 YEAR MINIMUM F/U
Results
CP1046688-1Years since THAYears since THA
Survival Survival free (%)free (%)Survival Survival free (%)free (%)
0
20
40
60
80
100
0 3 6 9 12 15 18 21 24 27 30
30 Year Survivorship Free of Any Component
Removal or Revision For Any Reason: 81.4%
Specific Issues in Hip Surgery for Younger Patients
• “Minimally Invasive Surgery”
• Resurfacing Operations
• Bearing Surfaces
M.I.S. Surgery
• Marketing rather than a scientific term
• Effort to perform joint surgery through smaller incisions– Goal of speeding patient
recovery
My Advice – Proceed with Caution
• You’re in this for the 20 year rather than the 20 day outcome– Very subtle differences in artificial hip and knee
alignment have a big impact in how long they last
– Scientific studies of MIS surgery have shown less predictable alignment than standard surgery
– Equal or greater damage to underlying muscles
– Computer assistance may erase this difference
Resurfacing Operations
vs
Resurfacing
• Potential Benefits– More normal loading of the
femur bone– Less bone resected– Easier revision surgery– Less dislocation
• Reasonable option if no deformity present
Bearing Surfaces
• Total hips are mechanical ball in socket joints– Wear debris leads to losening and failure
Bearing SurfacesBearing SurfacesHighly Cross-Highly Cross-
Linked PELinked PE
• VersatileVersatile• Small headsSmall heads
• WearWear• DislocationDislocation
Metal on metalMetal on metal
• Less wearLess wear• Head diameterHead diameter• IonsIons
• WomenWomen• YoungYoung
• AllergyAllergy
Ceramic on ceramicCeramic on ceramic
• Less wearLess wear• Limited optionsLimited options
• InsertsInserts• NeckNeck
• FractureFracture• SqueakingSqueaking
Joint Replacements
• Important points to remember- Joint replacements (arthroplasty) treat arthritis
well- Not a predictable treatment for weakness or
motion