First steps into the world of Orthopaedics: BOA 2022

As part of my induction into the world of Orthopaedics I attended the BOA annual congress 2022, held at the ICC Birmingham (September 2022).


As some of you may know, JointMedica is heavily focused on Hip Resurfacing, most of the people I work with here have been associated with this technology for many years. As I've started to get an understanding of the industry, I was surprised to see very few resurfacing devices at the event. So, naturally the question was asked...


"Why was Hip Resurfacing not featured or discussed at BOA annual congress 2022?"


The theme for the British Orthopaedic Association (BOA) Annual Congress 2022 was 'Technology, Data and Recovery', so you may be wondering why over the four-day event filled with lectures, debates, and discussions we failed to see hip resurfacing being mentioned in any capacity.


As a company who specialises in hip arthroplasty, we have seen and heard of the latest technological advances being made from other professionals and companies regarding Hip Resurfacing Arthroplasty (HRA). Including, the H1 Ceramic Hip Resurfacing from Embody and MatOrtho’ s ReCerf® Ceramic Hip Resurfacing; both believed to be awaiting results from their respective clinical trials.


Automatically, I had many unanswered questions including "Are we overly passionate about resurfacing?" and "Is Hip Resurfacing a 'Taboo' topic?"


From my research, and newly acquired knowledge I know that over the years we’ve seen various devices enter the market, including the Birmingham Hip Resurfacing system and the Adept system from MatOrtho which are now only permitted to be inserted into larger size active males. Most notably, Andy Murray (former world number 1 ranked singles tennis player) undertook hip resurfacing surgery back in 2019.


Mr Andrew Pearson (Medical Director and Consultant Orthopaedic Surgeon) stated “It is likely that Andrew Murray has been advised to choose the Birmingham Hip Resurfacing procedure because it provides him with the best chance at retaining as much movement and stability as possible. It is also the best procedure for conserving bone and offers excellent longevity which is important because he is still a young man. ​” ⁽¹⁾


With such well-known benefits as discussed by Mr Pearson, and continuous releases of journals and publications discussing said benefits, I find it difficult to believe there isn’t more of a spotlight on HRA.


In a recent publication⁽²⁾ (August 2022), a meta-analysis was conducted assessing the time for return to sport following hip resurfacing. The study concluded that “over 80% of patients were able to return to sport at 6 to 12 months after HRA”. Another study⁽³⁾ released in that very same month outlined that “Despite similar function and revision rates, HRA was seen to have lesser associated complications compared to THR and ionic levels may not be a detrimental issue. Hip resurfacing provides relative ease during revisions, especially in younger patients and it may be an alternative to THR in the younger population.”


Ionic levels have notoriously been known as one of the main reasons for the declined use of hip resurfacing arthroplasty. The increased “levels can lead to adverse reactions to metal debris (ARMD) and the formation of pseudo-tumours, which eventually leads to aseptic loosening and failure of the implant” ⁽⁴⁾. However, when we see that ionic levels may not be a “detrimental issue” as discussed above, and with Hip Arthroplasty specialists developing non-metal-on-metal devices it's come to mind that these issues may be a thing of the past.


Hip resurfacing has come a long way since the first introduction of modern metal-on-metal HRA in 1999. Over the last 20 years, specialists have been able to generate expertise and “know-how” to develop problem solving techniques which we know will be vital for the success of future devices, and hopefully bring Hip Resurfacing to the forefront of orthopaedics.


Let me know your thoughts...



Sources:

1. https://www.itv.com/news/central/2019-01-29/andy-murrays-pioneering-hip-surgery-was-first-developed-in-birmingham

2. https://pubmed.ncbi.nlm.nih.gov/36040530/

3. https://pubmed.ncbi.nlm.nih.gov/36006506/

4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6180337/






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