| More & more young & active patients | | | | in the older. |
| world wide are in need of hip replacement surgery. In | | | | However the attraction of a hip resurfacing drives |
| such cases, it is imperative to pay special attention to | | | | many females to ignore these risks and choose a hip |
| the technique to ensure a successful outcome & | | | | resurfacing. Dr.Venkatchalam discusses an alternate |
| longevity of the operation. Traditionally a total hip | | | | bone sparing safe approach in young & active |
| replacement was performed in the older age group. | | | | patients. These approaches combine the advantages |
| Young patients with hip pain either had to endure | | | | of a hip resurfacing and total hip replacement. Why |
| pain or subject themselves to a total hip replacement | | | | do you prefer the short stem ? The various short |
| with its inherent disadvantages of dislocation and life | | | | stem prostheses like the Proxima hip & METHA |
| span of 10 to 15 years. Now, recent advances in bio- | | | | combine the advantages of resurfacing & THR. |
| materials and techniques have made it possible for | | | | On the acetabular side a full range of options is |
| young patients to get a satisfactory & | | | | available to the surgeon. |
| successful outcome after a hip arthroplasty. Definition | | | | The force transfer in the femur is more proximal and |
| of a young patient - The deciding factor is not | | | | more biological. Lack of a distal stem component |
| necessarily the patient's age, but their activity level. | | | | eliminates the incidence of thigh pain. In addition these |
| Even many older patients like to play Tennis, Golf or | | | | implants open up the vast range of bio materials |
| participate in physical activity. This applies also to | | | | available. All bio-material combinations like metal on |
| anyone who can be expected to live for a long time, | | | | metal, metal on poly, ceramic on poly, ceramic on |
| is biologically (not chronologically) young and has good | | | | ceramic are possible. These promise excellent |
| bone quality. | | | | longevity. If a revision becomes necessary, then one |
| Today even septuagenarians meet these pre | | | | can switch to a standard stem. Some of these |
| requisites. Surgeons have to re think their | | | | models like the METHA hip make it possible for the |
| conventional strategy of putting in a total hip with a | | | | surgeon to tailor the implant to the individual's |
| metal on poly bearing. Resurfacing also poses several | | | | anatomy. What other innovations can you use to |
| un answered questions and cannot be considered as | | | | ensure a proper implant positioning? |
| a panacea. Causes leading to hip pain in young | | | | Navigation allows the surgeon to place the implant in |
| patients- Avascular necrosis is the leading cause | | | | the optimal position. What are the special |
| leading to hip arthritis followed by developmental | | | | considerations in Asian patients? Dysplasia and osteo |
| dysplasia of the hip. | | | | necrosis constitute the most common indications for |
| Perthes disease, slipped upper femoral epiphyses, | | | | total hip replacement in India & Asia. Primary |
| sickle cell disease and post traumatic arthritis are | | | | osteo-arthritis is rare. Moreover these patients are |
| other causes leading to the common outcome of | | | | younger and more active. Their social and religious |
| secondary osteo-arthritis . In middle and older | | | | habits such as sitting with crossed legs dictate to the |
| Caucasian patients, Primary osteoarthritis is the | | | | surgeon that he must use a prosthesis which |
| commonest cause of hip pain. Limitations of hip | | | | provides a large range of movement. Risk of |
| resurfacing Off late, hip resurfacing has been | | | | dislocation has to be reduced. |
| vigorously promoted on the internet as a possible | | | | Anatomic differences also exist. All these variables |
| & preferred treatment. However there are | | | | require a special implant concept and very wear |
| some inherent un answered problems with hip | | | | resistant materials with a large diameter. To |
| resurfacing. Elevated metal ion levels, metal allergy, | | | | summarize, treatment of hip arthritis in the young |
| metallosis are some of the side effects of metal on | | | | poses a challenge to surgeons and scientists. Hip |
| metal hip resurfacing. The long term impact of raised | | | | resurfacing while offering a possible solution has some |
| metal ion levels is unknown. Females in all age groups | | | | draw backs. Short stem prostheses with newer bio |
| are high risk candidates because of the risk of | | | | materials promise to overcome these deficiencies and |
| fertility curbs in young & femoral neck fracture | | | | offer a long lasting surgical outcome. |