Advanced Topics on Hip Resurfacing NYC May 2010

Overview of the Advanced Topics in Hip Resurfacing Course held at Hospital for Special Surgery (HSS) on May 7 & 8, 2010
in New York.

First my thoughts and Intro

Another exciting course, but this one, I personally felt was one of the best and informative conferences I have attended. The faculty was incredible, it was the who’s who of hip resurfacing surgeons and it covered a lot of extremely important topics in a short day and a half.  What a shame that more surgeons did not attend this because of the incredible information that was shared.  I really have to say that I am very disappointed in the many that I emailed that just could not bother to even reply to me and those that did that said they would not be there, what are they thinking?   I seriously hope that in the future more surgeons will take the initiative to better their education for the best interest of their future patients. I was very happy to see Dr. James Rector and Dr. Cynthia Kelly from Colorado both in attendance. I was really impressed at the enthusiasm Dr. Rector showed as well as the very apparent passion he has for this procedure.  I heard him arranging a time to fly out to Belgium to observe Koen De Smet in surgery so he can learn more.  He will also be attending the Advanced course coming up next month in Belgium.  I hope to see more surgeons in the future take the initiative to attend these courses as well as arrange to observe some of these top surgeons in surgery to better their techniques.  All patients should ask their surgeons about their training and more importantly what they have done to keep up with resurfacing, like attending any courses or flying out to observe other surgeons doing the procedure.  We as patients need to know that our surgeons are as excited about doing this procedure as we are at getting our active lives back.  I must say that I have a whole new level of respect for Dr. Rector now.  As of the conference he was just approaching 400 resurfacings.

3rd Annual Hip Resurfacing Course Overview September 2009

Now in no way is this any scientific paper.  It is just an overview written by a patient, with parts taken from the syllabus that was provided to me on a CD for accuracy purpose, please remember, this is from a patent’s perspective.

Dr. Edwin Su Overview of 3rd Advanced Resurfacing Course Ghent, Belgium June 2009

My overview of the 3^rd annual “Advanced Resurfacing Course in Ghent Belgium”

Overall, I was extremely impressed with the course. It was a thrill to be part of this faculty, since the lecturers were all long-time resurfacing experts who had a collective experience of more than 35,000 resurfacings!  The faculty included experts from around the world – from the US, Germany, UK, Australia, France, and of course, Belgium.

There were about 80 attendees, all surgeons who had done more than 20 resurfacings. Thus, it was an interested congress that made for a sophisticated discussion. The program was organized into specific mini-topics, all of which I found extremely interesting.  Fortunately, I can say that while nothing was that new in concept to me, it solidified beliefs and ideas that I have had about resurfacing. Also, I was able to share some of my own observations and experiences.

Below is a detailed account of the course topics. But to summarize, I would say that there was a lot of attention given to the recent reports of metal hypersensitivity, pseudotumor, and results in women.  Overall, the consensus was that these can be problems, but in a very small percentage (particularly hypersensitivity).  Pseudotumor seems to be related to accurate positioning of the implant, so once again, experience is key!!  As for female patients, results seem to be more related to component size rather than gender itself.   Despite our recognition that these issues can cause problems, the majority of the attendees remained dedicated resurfacing surgeons and would still continue to perform this life-changing operation. 

Dr. Edwin Su Overview of 2nd Annual U.S. Comprehensive Course on Total Hip Resurfacing Arthroplasty

Held in Los Angeles on October 24 & 25, 2008
By Dr. Edwin Su

Dr. Su notes on the Second Annual US Comprehensive Course on Total Hip Resurfacing Arthroplasty
I’ve typed up some of my notes from the course. In summary, I found that the main topics discussed were: results of hip resurfacing worldwide; technical aspects of hip resurfacing; patient selection; failures of resurfacing; and concerns about metal on metal joints.  The overarching theme, however, has become clearer and clearer in these conferences. Namely, that COMPONENT POSITION IS CRITICAL, and experience is paramount to get it right.

Dr. Rogerson Overview of 2nd Annual U.S. Comprehensive Course of Total Hip Resurfacing Arthroplasty

Vicky,

Here is my summary of the Second Annual U.S. Comprehensive Course on Total Hip Resurfacing Arthroplasty, October 24-25, 2008, Los Angeles, California.

Hope it is helpful,
John

Belgium Advanced Training Course for Surgeons, June 2008

By Vicky Marlow

It was very interesting to watch the doctors present from the doctors perspective but it is quite different coming from our side. When we look at it as OUR bodies they are cutting open, it changes the whole view. The following is my view as a patient. — Vicky

This overview of the conference I attended in Belgium, June 25 – 28, 2008 are notes that I took during the presentations and sessions as well as my own personal opinions and thoughts on the subject and some of what I understood while I was there. It is in no way any scientific data and if anyone does see anything that is inaccurate, please feel free to email me and correct me. I can be reached at contact Vicky. To summarize the conference in two sentences, first I will quote Mr. McMinn:

Bad results of Resurfacings are the result of badly done Resurfacing” — Derek McMinn

In conjunction with that, to quote Dr. DeSmet

A WELL DONE resurfacing works well, but is TECHNICALLY DIFFICULT.” — Koen DeSmet

AAOS Conference Hip Society Meeting

March 8, 2008

There was a lot of discussion about placement of the cup position.

Cup position with large open angles will cause more metal debris. It was agreed that in the past the doctors were more concerned about the placement of the femoral component but they are finding out that patients are having more long term problems with ROM (Range of Motion) or lack of ROM if the cup placement is off. The cup position is crucial to avoid impingement; they need to watch the anteversion and the orientation of the lip. The doctors should also take care to remove any osteophytes.

Miami Orthopedic Conference General Overview

I met so many wonderful doctors there, it was truly amazing. The hardest thing for me was getting used to calling them by their first names, that was weird! Some of the wonderful docs I had a chance to speak with in detail were Mr. McMinn, Mr. Treacy, Dr. Su, Dr. Rogerson, Dr. Ure, Dr. Raterman, Dr. Rector and Dr. Cynthia Kelly. I just had to meet one of the very few female resurfacing surgeons out there. I also met quite a few other doctors but did not have the opportunity to talk with them since time was so limited. The highlight of my trip besides meeting some of the greats was being able to attend the cadaver training, wow! What an experience, hopefully I will post some pictures of that shortly. All I can say is, I would not want to be a surgeon’s first.

Anterior vs Posterior Surgical Approaches

There seems to be a greater risk of nerve damage using the anterior approach due to the exposure of the sciatica, but the conclusion was that with attention to detail it was fine to use the anterior approach.

There was a bone scanning study done to study the vascularity of the posterior approach post surgery to find out if the posterior approach damages the blood supply. This study was done by Beule.

Unmatched Clinical Results of the BHR

From Hip Joint Course in Baltimore, Maryland, August 2010