Revision, Cup only? Save resurfacing?
Is it possible to save your resurfacing device if the femoral component is place correctly and only revise the cup?
Derek McMinn:
On Sep 12, 2011, at 10:30 AM, Derek McMinn wrote:
Hello Vicky,
Cup breakout can easily be addressed by cup only revision. I used to get this with the Corin device I used and I've successfully carried out several cup only revisions over the past 20 years. A large inventory needs to be available for revision surgery including thicker cups, dysplasia cups and THA cups with a BHR (or whatever other resurfacing device has been used) compatible liner. Much better to get on and revise the patients hip than mess around with MRI's & metal ion tests. (Vicky's comment: Derek is referring to devices other than recalled defective devices where the cup has slipped, patients should check with him on a case by case basis, I can get you in touch with him if you are in such a situation) Delay will only serve to guarantee edge wear of the loose vertical cup.
With the BHR in a series of 3205 cases until Dec 2010, I've had 2 late cup loosening 9 & 12 years post-op- no early breakouts. Early breakout with the BHR cup is either caused by poor surgery with a poor primary fix or too early return to high activity before cup osseo-integration happens.
Best regards
Derek