follow – up was performed on the Birmingham Mid Head Resection (BMHR) .. good surgical technique and a well proven resurfacing implant is vital for success . The novel Birmingham Mid-Head Resection (BMHR) device offers the option. We have illustrated the surgical technique to manage this rare. Surgery was conducted via a standard posterior approach to the hip joint using a 58 mm BHR acetabular component, a 52 mm BMHR femoral head implant and.
|Published (Last):||10 May 2009|
|PDF File Size:||5.73 Mb|
|ePub File Size:||18.67 Mb|
|Price:||Free* [*Free Regsitration Required]|
Published online Aug Olsen also describes two distinct fracture patterns: In our case, the fracture was complex, spiralling from the femoral neck to the subtrochanteric region. A clinicoradiologic study of the Birmingham Mid-Head Resection device.
Anteroposterior radiograph of the right hip showing periprosthetic fracture spiralling to the infratrochanteric region. Cadaveric studies have suggested that standard resurfacing arthroplasty fracture rates are reduced with slight valgus placement of the femoral component compared to anatomic position. Time will tell when further case reports, biomechanical and follow-up studies emerge if spiral subtrochanteric fractures are more common than suggested by current biomechanical studies.
The BMHR is made up of three components – the femoral stem, a modular head and an acetabular cup. The BHR procedure is typically unsuitable for patients with avascular necrosis AVNlarge femoral cysts, or patients with anatomical difficulties such as bmbr dysplasia or Perthes disease.
Copyright – This difference may represent the difference between laboratory tested axially loaded cadaveric femora and real life when a fall is more likely to result in rotation forces caused by the femoral head-neck anteversion. In these patients only a stemmed component was possible by removing bone stalk. A biomechanical investigation of implant alignment and femoral neck notching with the Birmingham Mid-Head Resection.
Smith and Nephew Inc.
Birmingham Mid Head Resection prosthesis is a recently developed hip prosthesis for patients
The BMHR prosthesis does not violate the femoral canal. You can find out more about this option by clicking here. We have illustrated the surgical technique to manage this rare complication.
This has been highlighted with an arrow in Fig. This paper illustrates the first reported case of a BMHR periprosthetic fracture.
Birmingham Mid-Head Resection Periprosthetic Fracture
Total hip arthroplasty in the young leads to difficult choices in implant selection. The femoral neck is prepared to receive the proximal load-bearing cone of the BMHR stem. National Center for Biotechnology InformationU. This is unlike the usual fracture pattern seen in conventional hip resurfacing arthroplasty and that seen in cadaveric BMHR studies.
No potential conflict of interest relevant to this article was reported.
Find articles by Jonathan Jeffers. Bose of ARCH is one of the very few surgeons in the world to perform this surgery. Femoral neck fractures after metal-on-metal total hip resurfacing: The shape of the BMHR femoral stem is conical and is said to allow for improved physiologic loading similar to that of the intact femur. Surgeons come from around the world to observe and train with Mr McMinn in Birmingham. It was increasingly becoming obvious that some younger active patients were not candidates for resurfacing due usrgical some technical issues.
Patients who would normally be considered for resurfacing but have been otherwise excluded due to poor femoral head quality now have an option other than total hip replacement. Patient was on self eurgical with steroids. The remaining femoral bone is then prepared into a conical shape and a matching stem is tapped into technjque without the need for cement or screws.
Birmingham Mid-Head Resection Periprosthetic Fracture
Our current protocol for symptomatic early AVN. Having performed over Metal-on-Metal Hip Resurfacings over the course of 20 years, he is the most experienced surgeon in this field. This implant is a novel solution to addressing this challenging group of patients. This fracture pattern is different from published cadaveric studies, and clinicians using this implant should be aware of this as revision is likely to require a distally fitting, rather than a metaphyseal fitting stem.
Anteroposterior radiograph showing valgus placement of the Birmingham Mid-Head Resection in the right hip and notching of the superior lateral cortex arrow. Risk of periprosthetic femoral neck fracture after hip resurfacing arthroplasty: The BMHR is built on the clinical success of the BHR, offering all the advantages of a hip resurfacing – a good range of movement, excellent stability, reduced risk of dislocation and better revision options than a THR.
Click here to view the main website. This will be of great clinical significance as revision surgery will be more technically challenging and may result in longer operating times, greater blood loss, longer hospital stays and poorer patient satisfaction outcomes although it should be emphasised that it is still too early to tell.
Received Jan 11; Accepted May Adaptive bone remodeling of the Birmingham hip mid head resection. Femoral neck fracture following hip resurfacing: Early results with this type of CoM device show significantly lower metal wear than with any metal-on-metal hip replacement, making it a safer procedure for patients with metal allergies.