Is Hip Resurfacing Right for You?

[@CarolAnneChapman]

It never occurred to me that young tennis players would need hip replacements. I thought it was only for seniors! I guess you learn something every day! Thanks for a great video!

[@Lathamhipsurgery]

Thanks Carol. They are very hard on their joints…

[@leemcdermott1770]

No way your never retiring your the best of there best.x

[@Lathamhipsurgery]

You are a legend Lee! Have a great weekend my friend.

[@dichebach]

I am across the pond, 16 days post surgery on a left side total hip arthroplasty. My understanding is that my implants are a combination of metal, ceramic and plastic. I see my surgeon again in about 3 weeks and I want to get the spec sheet on the device so I know what I'm made of! So far things seem to be going well. I've been able to manage short street walks in the 500m ballpark everyday for the past week or so, and the PT started the day after surgery.

[@Lathamhipsurgery]

Sounds good. Most THRs are made of those materials. All of the different manufacturers' implants look very similar.

[@pudster1960]

Thanks for another great update, I am holding on for Bilateral recerf, if it is suitable for me. Paul

[@PacLevkov]

Hi, I'm 33y old, diagnosed with AVN 3y ago. Doctors offered me THR, saying that Recerf will not last long and I need to do revision surgery. Is that correct? I understand now that there is ceramic recerf, which may be better option for me, as I have less than 5% pain doing my daily work activities and if needed, I can wait enough to have the Recerf. I have two questions: 1. Is the AVN Compatible with Recerf? 2. If yes, since my head is colapsing, how does the space between the cap (recerf) and the bone of the femor is filled ? Is it empty? Does the bone starts to grow until it reach the cap? Would be glad if you can elaborate.

[@Lathamhipsurgery]

If the AVN is extensive in the head of the femur, there isn't enough healthy bone to use a resurfacing. We look at the bone quality using radiographs and MRI, but we have tom make a final decision at the time of surgery. If there isn't enough good quality bone, you wake up with a hip replacement.

[@andysedgwick5783]

Good video and an informative update- thanks. However, I notice that you don’t mention the competition. The Ceramic H1 Hip Resurfacing implants currently being developed by the fantastic Prof Justin Cobb and his amazing team at Imperial College, London. Like Recerf, H1 isn’t yet available commercially as it completes the approval process, however, it may be available via a clinical trial. Having personally benefitted from bilateral hip resurfacing with H1 implants just over 3 years ago, I can say that they’ve given me back a full and active life - truly life changing.

[@Lathamhipsurgery]

Good to hear you’ve done well with the H1. I haven’t heard anything about when/if it will be available for general use.

[@michaelblackmore883]

I was told probably early 2025.

[@Lathamhipsurgery]

@@michaelblackmore883We can dream....!

[@michaelblackmore883]

@@Lathamhipsurgery a strange response.

[@Lathamhipsurgery]

@@michaelblackmore883why?

[@DB-fc2gf]

Hi Jeremy. I have a BHR installed on my left hip now at 6 months post op. I really didn’t want MOM but felt I couldn’t wait for COC to enter the UK. Now realised I should of found the money and travelled to Belgium - hindsight hey! Anyhow have you got a date for this yet? My right hip is showing signs but isn’t ready yet so I can hold off. Many thanks.

[@Lathamhipsurgery]

BHR is an excellent device with outstanding results so it was a good choice. As far as I know ReCerf is still on track for December 2024.

[@DB-fc2gf]

@@LathamhipsurgeryYes the BHR does but the Adept seems to have a better revision rate and is easy for surgeons to fit? Mines clunky.

[@Lathamhipsurgery]

@@DB-fc2gf There's nothing much between them TBH. I've done hundreds of both Adept and BHR. I prefer the Adept instruments.

[@DB-fc2gf]

@@LathamhipsurgeryI’m assuming the COC will have the similar instruments as the Adept? Looking forward to the results of COC over metal as it could be the future with resurfacing… time will tell.

[@planet_69]

Hi Jeremy, I hope you are well, I went abroad to Lithuania four months ago for a dual mobility hip implant. The surgeon seemed evasive when I asked questions about the implant, before and after the operation. Anyway I just got my x-rays after 3 months from the NHS which I have just sent to them to satisfy their garrantee. They seem poor quality, and I can't help thinking they have put in a standard prosthetic instead. Would you be interested in taking a look if I sent you the x-rays. If they are not clear enough I will go private for better x-rays.

[@Lathamhipsurgery]

Thanks for your comment. I'd be happy to look at the radiographs. Please send the images to the email address in the description.

[@arronjoseph9200]

Ive been trying to follow all studies on ceramic resurfacing. Its doing well in other countrys. Im a 36 year old male, was extremely active. Now id just say im active. I have moderately severe oa in both hips and think ceramic resurfacing will be a better option for me. Im so eager for this but feel like im left in the dark waiting. I feel ill bite the bullet soon and opt for a THR and just miss out on ceramic resurfacing 😢

[@Lathamhipsurgery]

The ReCerf is still on course for November/December. I’ll post a video when it’s confirmed.

[@arronjoseph9200]

@Lathamhipsurgery thank you sir, my next question and concern is how do I even go about getting this done or on the list. I truly believe I'd be a prime candidate (given my xrays says I am) I'm very disciplined and determined. I still try to train in the gym with limitations so therefore believe ill work well with the aftercare team and physios.

[@Lathamhipsurgery]

@@arronjoseph9200 There will be a few surgeons like me in the UK who will be able to use the ReCerf. It's unlikely that it will be available on the NHS for quite a while given the expense and limited data. If you are interested in having an assessment, please contact the office. The details are in the description.

[@terragibbia4670]

Why is resurfacing only for younger patients?

[@Lathamhipsurgery]

Because when you use it in older people there is an increased risk of failure compared to a hip replacement. It’s related to bone quality which deteriorates as we get older.

[@terragibbia4670]

@@Lathamhipsurgery KZbin: "New hip resurfacing implant could lead to better outcomes in patients" 0:55 - Trial of patients 18-70 yrs old in London. How can hammering a stem into a femur which has deteriorated as we get older, have less of a failure rate compared to not using a stem at all?

[@terragibbia4670]

@@Lathamhipsurgery NIH: "Intraoperative proximal femoral fracture is a risk in THA with cementless stems with reported rates of 1.5 - 27.8%." BMC Musculoskeletal Disorders: "Periprosthetic femoral fracture is among the most common causes of revision of primary total hip arthroplasty (20.7%), after loosening (24.6%), and quite the same of dislocation (20.8%). These numbers consider both immediate preoperative fractures and late postoperative events." From what I understand, the majority of surgeons will not do resurfacing since increased education and skill is paramount and it is a more costly procedure to perform.

[@Lathamhipsurgery]

@@terragibbia4670in the UK most hip surgeons will use a cemented stem in older people. The stem is pushed into the cement with no hammering needed.

[@Lathamhipsurgery]

@@terragibbia4670many surgeons were put off resurfacing because of the problems associated with reactions to metal wear products. Younger surgeons might never have seen resurfacing surgery in their training.

[@AndréSimões-f4k]

Is BHR mom, which has been on the market since 1996, still the same as it is today? Or do you already hear updates on materials? The quality of the metal is the same. or evolved? I ask this because I don't see anything talking about it. In almost 30 years there has been no evolution?

[@Lathamhipsurgery]

The original Midland Medical Technology BHR was made by Mike Tuke at Finsbury Orthopaedics in Leatherhead. Smith and Nephew bought MMT in 2003 and acquired the BHR. S&N then manufactured the BHR in its own factory. Nothing has changed in terms of the alloy and bearing clearance. Finsbury became MatOrtho. It started making the Adept resurfacing in 2004. Many of us regard it as BHR 2.0. It is Mike Tuke’s design. It’s the same alloy and bearing but with better instruments to put it in. I started with BHR in 1998 but have used the Adept since 2004. It’s the only device that’s been made in the same factory since it was introduced. The results are excellent.

[@AndréSimões-f4k]

@@Lathamhipsurgery Thank you very much for the answer 👍

[@tdim4309]

Any idea if ceramic recerf squeaks?

[@Lathamhipsurgery]

All ceramic bearings squeak or rumble from time to time. Some people’s hips squeak on every step.