July/August 2007

PAMF’s Center for Total Joint Replacement now offers patients with hip pain a more conservative alternative to total hip replacement. In May 2006, the U.S. Food and Drug Administration (FDA) approved the Birmingham Hip Resurfacing (BHR) system, a technologically advanced surgical procedure that resurfaces rather than replaces the end of the femur (thigh bone). This allows patients to participate in more strenuous physical activity with an implant that is potentially more stable and longer lasting than traditional total hip replacements. And if future revision surgery is required, it may be a less complex procedure.

PAMF orthopedic surgeons James M. Hartford and John V. Lannin of the Orthopedics Department’s Center for Total Joint Replacement perform BHR and together have more than 30 years of experience in joint replacement surgery. In 2006, Dr. Hartford received training on the BHR procedure in Canada, and Dr. Lannin trained in England with Dr. Derek McMinn, developer of the BHR surgery prosthesis. In addition, both Drs. Hartford and Lannin have completed advanced fellowship training in joint replacement surgery and work together to provide patients with the most comprehensive care possible.

Although the BHR implant is not brand new − it has been in use around the world since 1997 and has since been implanted more than 60,000 times − the FDA approved the procedure with the requirement that surgeons receive specific training. To date, only a limited number of surgeons have been trained in this specialized procedure.

"Dr. Lannin and I were approached by the manufacturers to receive BHR training because we are fellowship-trained surgeons who have performed hip replacement and resurfacing surgeries for several years," said Dr. Hartford.

"We have been performing the BHR surgeries at PAMF together, and this has two main benefits: patients undergo surgery with two highly trained physicians, and Dr. Hartford and I are able to collaborate and provide our surgical expertise as a team," added Dr. Lannin.

Whereas total hip replacement requires the removal of the femoral head and the insertion of a hip stem down the shaft of the femur, hip resurfacing preserves the femoral head and the femoral neck. During the procedure, the surgeon only removes a few centimeters of bone around the femoral head, shaping it to fit tightly inside the BHR implant.

The implant’s head size, its bearing surfaces and its bone-sparing technique make it a preferred choice for young, active patients. Although the implant’s rate of survivorship is comparable to standard total hip replacements after five years, these three key advantages set the resurfacing technique and implant apart from its total hip replacement counterparts. "The hip resurfacing surgery is really aimed at the younger person who wants to return to sports like skiing, surfing, playing tennis, biking and other physical activities," said Dr. Hartford.

Although hip resurfacing is intended for young, active adults who are under 60 years of age and in need of a hip replacement, adults over 60 who are living non-sedentary lifestyles may also be considered for this procedure. Patients should talk to their orthopedic surgeon to determine if hip resurfacing is the right option for them.

For more information, contact the PAMF Center for Total Joint Replacement at (650) 853-2343 or visit www.pamf.org/joints/procedures/birmingham.