hip pain in the active patient - sparrow health systemalternative bearing surfaces wear of current...
TRANSCRIPT
![Page 1: Hip pain in the active patient - Sparrow Health SystemAlternative Bearing Surfaces Wear of current ceramic and metal hip replacements are virtually immeasureable All-metal total hip](https://reader034.vdocuments.net/reader034/viewer/2022050510/5f9ac1806ef27b62c436e155/html5/thumbnails/1.jpg)
Jason Cochran D.O.
Michigan Orthopedic Center
Sparrow Health System
Lansing, MI
517-267-0200
Hip pain in the active patient
![Page 2: Hip pain in the active patient - Sparrow Health SystemAlternative Bearing Surfaces Wear of current ceramic and metal hip replacements are virtually immeasureable All-metal total hip](https://reader034.vdocuments.net/reader034/viewer/2022050510/5f9ac1806ef27b62c436e155/html5/thumbnails/2.jpg)
Who is the active patient?
![Page 3: Hip pain in the active patient - Sparrow Health SystemAlternative Bearing Surfaces Wear of current ceramic and metal hip replacements are virtually immeasureable All-metal total hip](https://reader034.vdocuments.net/reader034/viewer/2022050510/5f9ac1806ef27b62c436e155/html5/thumbnails/3.jpg)
Why do you hurt?
![Page 4: Hip pain in the active patient - Sparrow Health SystemAlternative Bearing Surfaces Wear of current ceramic and metal hip replacements are virtually immeasureable All-metal total hip](https://reader034.vdocuments.net/reader034/viewer/2022050510/5f9ac1806ef27b62c436e155/html5/thumbnails/4.jpg)
Goals
Causes of hip painNonsurgical optionsSurgical optionsFinal thoughts
![Page 5: Hip pain in the active patient - Sparrow Health SystemAlternative Bearing Surfaces Wear of current ceramic and metal hip replacements are virtually immeasureable All-metal total hip](https://reader034.vdocuments.net/reader034/viewer/2022050510/5f9ac1806ef27b62c436e155/html5/thumbnails/5.jpg)
Socket– Cartilage – Labrum
Ball– Smooth weight-
bearing surfaces
Smooth cartilage
Anatomy of a hip
![Page 6: Hip pain in the active patient - Sparrow Health SystemAlternative Bearing Surfaces Wear of current ceramic and metal hip replacements are virtually immeasureable All-metal total hip](https://reader034.vdocuments.net/reader034/viewer/2022050510/5f9ac1806ef27b62c436e155/html5/thumbnails/6.jpg)
Labral Tears
Often misdiagnosed as “groin pull”Cartilage tears of the hipCommon cause of pain in young athleteMechanical symptoms of catching, clickingSimilar to meniscal tear of knee
![Page 7: Hip pain in the active patient - Sparrow Health SystemAlternative Bearing Surfaces Wear of current ceramic and metal hip replacements are virtually immeasureable All-metal total hip](https://reader034.vdocuments.net/reader034/viewer/2022050510/5f9ac1806ef27b62c436e155/html5/thumbnails/7.jpg)
Labral Tears
Diagnosed by examConfirmed with MRI arthrogram
![Page 8: Hip pain in the active patient - Sparrow Health SystemAlternative Bearing Surfaces Wear of current ceramic and metal hip replacements are virtually immeasureable All-metal total hip](https://reader034.vdocuments.net/reader034/viewer/2022050510/5f9ac1806ef27b62c436e155/html5/thumbnails/8.jpg)
Impingement
DevelopmentalabnormalityCan affect either the femoral head or the socketCan precedeosteoarthritis
![Page 9: Hip pain in the active patient - Sparrow Health SystemAlternative Bearing Surfaces Wear of current ceramic and metal hip replacements are virtually immeasureable All-metal total hip](https://reader034.vdocuments.net/reader034/viewer/2022050510/5f9ac1806ef27b62c436e155/html5/thumbnails/9.jpg)
Impingement
Occurs when the head is out of round!Leads toosteoarthritis
![Page 10: Hip pain in the active patient - Sparrow Health SystemAlternative Bearing Surfaces Wear of current ceramic and metal hip replacements are virtually immeasureable All-metal total hip](https://reader034.vdocuments.net/reader034/viewer/2022050510/5f9ac1806ef27b62c436e155/html5/thumbnails/10.jpg)
Osteoarthritis (OA)
• “Wear and tear”arthritis
• Symptoms of groin pain and lateral hip pain
• Often confused with groin pull, or a hernia
![Page 11: Hip pain in the active patient - Sparrow Health SystemAlternative Bearing Surfaces Wear of current ceramic and metal hip replacements are virtually immeasureable All-metal total hip](https://reader034.vdocuments.net/reader034/viewer/2022050510/5f9ac1806ef27b62c436e155/html5/thumbnails/11.jpg)
Osteoarthritis (OA)
• Joint becomes pitted, eroded
• Bone spurs form
![Page 12: Hip pain in the active patient - Sparrow Health SystemAlternative Bearing Surfaces Wear of current ceramic and metal hip replacements are virtually immeasureable All-metal total hip](https://reader034.vdocuments.net/reader034/viewer/2022050510/5f9ac1806ef27b62c436e155/html5/thumbnails/12.jpg)
Avascular necrosis (AVN)
– Caused when there is a disruption of the blood supply to the hip
– Leading causes: Alcohol, corticosteroids(asthmatics, chronic lung disease), unknown
– Other risk factors: blood vessel blockage due to sickle cell anemia, or from trauma
![Page 13: Hip pain in the active patient - Sparrow Health SystemAlternative Bearing Surfaces Wear of current ceramic and metal hip replacements are virtually immeasureable All-metal total hip](https://reader034.vdocuments.net/reader034/viewer/2022050510/5f9ac1806ef27b62c436e155/html5/thumbnails/13.jpg)
Now that we know the problem, what do we do about it?
![Page 14: Hip pain in the active patient - Sparrow Health SystemAlternative Bearing Surfaces Wear of current ceramic and metal hip replacements are virtually immeasureable All-metal total hip](https://reader034.vdocuments.net/reader034/viewer/2022050510/5f9ac1806ef27b62c436e155/html5/thumbnails/14.jpg)
Non-surgical alternatives–Lifestyle
modification–Exercise and
physical therapy–Anti-
inflammatorymedication
–Ambulatory aidsIe: cane, walker
![Page 15: Hip pain in the active patient - Sparrow Health SystemAlternative Bearing Surfaces Wear of current ceramic and metal hip replacements are virtually immeasureable All-metal total hip](https://reader034.vdocuments.net/reader034/viewer/2022050510/5f9ac1806ef27b62c436e155/html5/thumbnails/15.jpg)
Non-surgical alternatives
Most patients demand an active lifestyle
![Page 16: Hip pain in the active patient - Sparrow Health SystemAlternative Bearing Surfaces Wear of current ceramic and metal hip replacements are virtually immeasureable All-metal total hip](https://reader034.vdocuments.net/reader034/viewer/2022050510/5f9ac1806ef27b62c436e155/html5/thumbnails/16.jpg)
Surgical alternative
Hip ArthroscopyHip resurfacingHip replacement– Less invasive surgery– Advanced bearing surface
![Page 17: Hip pain in the active patient - Sparrow Health SystemAlternative Bearing Surfaces Wear of current ceramic and metal hip replacements are virtually immeasureable All-metal total hip](https://reader034.vdocuments.net/reader034/viewer/2022050510/5f9ac1806ef27b62c436e155/html5/thumbnails/17.jpg)
Hip arthroscopy
OverviewExcellent option for hipsLabral tearsLoose cartilageInflammation of the joint
![Page 18: Hip pain in the active patient - Sparrow Health SystemAlternative Bearing Surfaces Wear of current ceramic and metal hip replacements are virtually immeasureable All-metal total hip](https://reader034.vdocuments.net/reader034/viewer/2022050510/5f9ac1806ef27b62c436e155/html5/thumbnails/18.jpg)
Hip arthroscopy
BenefitsSmaller incisionsQuicker recoveryOutpatient surgery
![Page 19: Hip pain in the active patient - Sparrow Health SystemAlternative Bearing Surfaces Wear of current ceramic and metal hip replacements are virtually immeasureable All-metal total hip](https://reader034.vdocuments.net/reader034/viewer/2022050510/5f9ac1806ef27b62c436e155/html5/thumbnails/19.jpg)
Hip Resurfacing– Two FDA approved– BHR-Smith Nephew– Cormet-Stryker– 99.5% of patients
were “Pleased”or “Extremely Pleased”with the results
![Page 20: Hip pain in the active patient - Sparrow Health SystemAlternative Bearing Surfaces Wear of current ceramic and metal hip replacements are virtually immeasureable All-metal total hip](https://reader034.vdocuments.net/reader034/viewer/2022050510/5f9ac1806ef27b62c436e155/html5/thumbnails/20.jpg)
Who is the typical candidatefor Hip resurfacing?
– Adults under age 60 with active lifestyles
– Active adults over age 60 may be candidates, depending on their bone quality
![Page 21: Hip pain in the active patient - Sparrow Health SystemAlternative Bearing Surfaces Wear of current ceramic and metal hip replacements are virtually immeasureable All-metal total hip](https://reader034.vdocuments.net/reader034/viewer/2022050510/5f9ac1806ef27b62c436e155/html5/thumbnails/21.jpg)
What is Hip Resurfacing?
![Page 22: Hip pain in the active patient - Sparrow Health SystemAlternative Bearing Surfaces Wear of current ceramic and metal hip replacements are virtually immeasureable All-metal total hip](https://reader034.vdocuments.net/reader034/viewer/2022050510/5f9ac1806ef27b62c436e155/html5/thumbnails/22.jpg)
Hip Resurfacing
Healthy hip Cuts Implantcomponents
Implanted
![Page 23: Hip pain in the active patient - Sparrow Health SystemAlternative Bearing Surfaces Wear of current ceramic and metal hip replacements are virtually immeasureable All-metal total hip](https://reader034.vdocuments.net/reader034/viewer/2022050510/5f9ac1806ef27b62c436e155/html5/thumbnails/23.jpg)
Is hip resurfacing Minimally invasive?
![Page 24: Hip pain in the active patient - Sparrow Health SystemAlternative Bearing Surfaces Wear of current ceramic and metal hip replacements are virtually immeasureable All-metal total hip](https://reader034.vdocuments.net/reader034/viewer/2022050510/5f9ac1806ef27b62c436e155/html5/thumbnails/24.jpg)
That depends on how you define “Minimally Invasive.”
– Soft TissueNo. Incision length of 6 to 8 inches
– BoneYes. Preserves your body’s natural bone structure; It resurfaces rather than replaces
Conserved bone
![Page 25: Hip pain in the active patient - Sparrow Health SystemAlternative Bearing Surfaces Wear of current ceramic and metal hip replacements are virtually immeasureable All-metal total hip](https://reader034.vdocuments.net/reader034/viewer/2022050510/5f9ac1806ef27b62c436e155/html5/thumbnails/25.jpg)
The key benefits– Head size– Advanced bearing
surface– Bone conservation
![Page 26: Hip pain in the active patient - Sparrow Health SystemAlternative Bearing Surfaces Wear of current ceramic and metal hip replacements are virtually immeasureable All-metal total hip](https://reader034.vdocuments.net/reader034/viewer/2022050510/5f9ac1806ef27b62c436e155/html5/thumbnails/26.jpg)
Head Size and Bone Conserving
Closely matches the size of your natural femoral head
Preserves your natural femoral neck
Healthy headresurfaced head
Total hip head
![Page 27: Hip pain in the active patient - Sparrow Health SystemAlternative Bearing Surfaces Wear of current ceramic and metal hip replacements are virtually immeasureable All-metal total hip](https://reader034.vdocuments.net/reader034/viewer/2022050510/5f9ac1806ef27b62c436e155/html5/thumbnails/27.jpg)
Bone conservation (cont.)
– Revises to a primary
If you need “revision” surgery, you don’t get a revision implantThe follow-up procedure would be the same total hip replacement you would otherwise have received
![Page 28: Hip pain in the active patient - Sparrow Health SystemAlternative Bearing Surfaces Wear of current ceramic and metal hip replacements are virtually immeasureable All-metal total hip](https://reader034.vdocuments.net/reader034/viewer/2022050510/5f9ac1806ef27b62c436e155/html5/thumbnails/28.jpg)
What other options do I have?
![Page 29: Hip pain in the active patient - Sparrow Health SystemAlternative Bearing Surfaces Wear of current ceramic and metal hip replacements are virtually immeasureable All-metal total hip](https://reader034.vdocuments.net/reader034/viewer/2022050510/5f9ac1806ef27b62c436e155/html5/thumbnails/29.jpg)
Conventional hip replacement
Most successful surgery in orthopedicsUp to 99% 10 year survivorship
![Page 30: Hip pain in the active patient - Sparrow Health SystemAlternative Bearing Surfaces Wear of current ceramic and metal hip replacements are virtually immeasureable All-metal total hip](https://reader034.vdocuments.net/reader034/viewer/2022050510/5f9ac1806ef27b62c436e155/html5/thumbnails/30.jpg)
Who is a candidate?
Any patient with advanced arthritisFemale patients >60 years old or males with osteoporosis
![Page 31: Hip pain in the active patient - Sparrow Health SystemAlternative Bearing Surfaces Wear of current ceramic and metal hip replacements are virtually immeasureable All-metal total hip](https://reader034.vdocuments.net/reader034/viewer/2022050510/5f9ac1806ef27b62c436e155/html5/thumbnails/31.jpg)
Conventional hip replacement
Healthy hip Cuts Implantcomponents
Implanted
![Page 32: Hip pain in the active patient - Sparrow Health SystemAlternative Bearing Surfaces Wear of current ceramic and metal hip replacements are virtually immeasureable All-metal total hip](https://reader034.vdocuments.net/reader034/viewer/2022050510/5f9ac1806ef27b62c436e155/html5/thumbnails/32.jpg)
What has improved in hip surgery?
Alternative bearingsLess invasive approachQuicker recovery – Better pain
management– Rapid recovery therapy
![Page 33: Hip pain in the active patient - Sparrow Health SystemAlternative Bearing Surfaces Wear of current ceramic and metal hip replacements are virtually immeasureable All-metal total hip](https://reader034.vdocuments.net/reader034/viewer/2022050510/5f9ac1806ef27b62c436e155/html5/thumbnails/33.jpg)
Alternative Bearing Surfaces
Advances in bearingsurfaces=less wearless wear=longer survival
![Page 34: Hip pain in the active patient - Sparrow Health SystemAlternative Bearing Surfaces Wear of current ceramic and metal hip replacements are virtually immeasureable All-metal total hip](https://reader034.vdocuments.net/reader034/viewer/2022050510/5f9ac1806ef27b62c436e155/html5/thumbnails/34.jpg)
Alternative Bearing Surfaces
Wear of current ceramic and metal hip replacements are virtuallyimmeasureableAll-metal total hip replacementsreduce joint wear by 97% versus metal on plastic total hips
![Page 35: Hip pain in the active patient - Sparrow Health SystemAlternative Bearing Surfaces Wear of current ceramic and metal hip replacements are virtually immeasureable All-metal total hip](https://reader034.vdocuments.net/reader034/viewer/2022050510/5f9ac1806ef27b62c436e155/html5/thumbnails/35.jpg)
Less invasive
Incision– Around 4 inches in
length
Smallerincisions=better pain control and decreased blood loss
![Page 36: Hip pain in the active patient - Sparrow Health SystemAlternative Bearing Surfaces Wear of current ceramic and metal hip replacements are virtually immeasureable All-metal total hip](https://reader034.vdocuments.net/reader034/viewer/2022050510/5f9ac1806ef27b62c436e155/html5/thumbnails/36.jpg)
Improved RehabAfter surgery
– Patients undergo a rapid recovery protocol
– Better pain management protocols
– Up at bedside that day– Walking the next day– Achieve Therapy goals by
post op day one or two
![Page 37: Hip pain in the active patient - Sparrow Health SystemAlternative Bearing Surfaces Wear of current ceramic and metal hip replacements are virtually immeasureable All-metal total hip](https://reader034.vdocuments.net/reader034/viewer/2022050510/5f9ac1806ef27b62c436e155/html5/thumbnails/37.jpg)
What can I do after surgery?
– During year-one: Low-impact activities as your bone and muscles adjust to the new stresses (swimming, walking, bicycling)
– After year-one: Higher impact physical activity may be appropriate (doubles tennis, jogging)
![Page 38: Hip pain in the active patient - Sparrow Health SystemAlternative Bearing Surfaces Wear of current ceramic and metal hip replacements are virtually immeasureable All-metal total hip](https://reader034.vdocuments.net/reader034/viewer/2022050510/5f9ac1806ef27b62c436e155/html5/thumbnails/38.jpg)
Final Thoughts?
When and Who?
![Page 39: Hip pain in the active patient - Sparrow Health SystemAlternative Bearing Surfaces Wear of current ceramic and metal hip replacements are virtually immeasureable All-metal total hip](https://reader034.vdocuments.net/reader034/viewer/2022050510/5f9ac1806ef27b62c436e155/html5/thumbnails/39.jpg)
When should I have a Hip Replacement ?ArthritisPain that interefereswith Daily activities and Quality of LifeAll non-surgical treatment fails to relieve pain
![Page 40: Hip pain in the active patient - Sparrow Health SystemAlternative Bearing Surfaces Wear of current ceramic and metal hip replacements are virtually immeasureable All-metal total hip](https://reader034.vdocuments.net/reader034/viewer/2022050510/5f9ac1806ef27b62c436e155/html5/thumbnails/40.jpg)
Who should I choose to perform my Hip Replacement?
Orthopedic Surgeon– Regularly performs Hip Replacement Surgery– Specialized Training?– Fellowship?– Someone you are comfortable with
![Page 41: Hip pain in the active patient - Sparrow Health SystemAlternative Bearing Surfaces Wear of current ceramic and metal hip replacements are virtually immeasureable All-metal total hip](https://reader034.vdocuments.net/reader034/viewer/2022050510/5f9ac1806ef27b62c436e155/html5/thumbnails/41.jpg)
Q&APhysician:Dr.Jason Cochran Practice: Michigan Orthopedic CenterAddress: 2815 South Pennsylvania avenueContact: 517-267-0200