Ceramic Surfaces in Hip Replacement Surgery - Can We Improve Long Term Results in Younger, Active Patients?
By Arnold Yashar, M.D.
Approximately 300,000 patients each year undergo hip replacement surgery in this country alone. When medicines and activity modifications do not provide adequate relief of hip pain due to arthritis, or various other causes, this procedure has proven to be highly effective. In the short term, less than 10 years, rates of patient satisfaction with modern hip replacements are typically 98-99 percent. pikkelysömör kezelése házilag
The first successful hip replacements were developed in England in the late 1960s. At that time, the implants would attach to the bone with cement, and the new joint surface would consist of a metal ball articulating with a plastic socket. Although that system provided a high success rate initially, the implants tended to get loose over time, as the cement failed. Subsequently, we have improved our cement and the technique for its insertion, as well as implant longevity. macho man nebenwirkungen
Research to improve the implant designs and coatings has led to fixation of the implants to bone without cement. Since the bond is biologic, we do not expect the implants to come loose without a secondary cause. Now that our fixation is much better, the greatest cause of late failure is due to wear of the bearing surface. The gold standard is still the metal ball and the plastic socket. As the plastic wears, it creates particles, which cause an inflammatory reaction in the joint. This leads not only to pain, but destruction of bone and subsequent implant loosening. where i can buy bustural cream
Despite this mode of implant failure, for the typical patient, these standard implants are expected to last a lifetime. Success rates are up to 95 percent at 15 years, and up to 75 percent at 30 years. Since the implants last longer, physicians have been more willing to offer this procedure to younger patients. Initially, it was not recommended to perform this operation on a patient less than 65 years old, and now nearly one third of patients are under 65. We have found that the younger, more active patient develops wear much sooner than the studies mentioned above, which included older patients. This has led us to seek a better bearing surface to be used in a high-demand patient. CQ600 Plus
Wear is related to the amount of activity performed by the patient, and the amount of time they have to live. Ceramics can be processed into an implant that is the second hardest material on Earth (behind diamonds). In addition, the surface can be polished to a smoother surface than metal or plastic. We test implants on a device that simulates the stress and motion of walking. This system allows us to follow the wear that would happen in a person over years, but only requires months in the lab. Wear rates of modern ceramic surfaces are 2,000 times less than metal on plastic. Since there is minimal wear in the laboratory, we expect much longer implant survival in the patient who is at risk for wear: the young, active person. Although ceramics were first used in 1974, early versions would occasionally fracture. Due to design and material improvements, modern ceramics are thought to be at much less risk for this problem. Clinical trials on modern ceramic implants started in 1996 on approximately 1,500 patients. These implants have done so well that the FDA for general use approved this system in February 2003. triapidix300
Hip replacement surgery has been a highly successful procedure in terms of restoring function, and providing pain relief. As our longevity increases, so must our technology improve to allow for implants that can last the patient''s lifetime, even if that will be several decades from now. Ceramic surfaces show the best promise to achieve that goal. Ask your orthopaedic surgeon if you are a candidate for this procedure. perle bleue
Arnold Yashar, M.D., graduated from the Northwestern University School of Medicine. He attended the University of Michigan Hospitals for his general surgery internship and his Orthopaedic Surgery Residency. He completed a joint replacement fellowship at the Scripps Clinic and Research Foundation in San Diego, CA. Dr. Yasher is in private practice with the Bluegrass Orthopaedic Group. He is also a clinical assistant professor of orthopaedic surgery at the University of Louisville.
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