A Joint Venture Is the New Hip Thing
By JAMES TARANTO
Warwick, England
I am a natural-born American, but part of me was made in England. I've come to this town, 25 miles southeast of Birmingham, to find out how.
The hum of machines is ubiquitous in the Smith & Nephew factory, where the floor is divided into "cells" the size of small rooms, each a self-contained assembly line making a particular part. Workers in a cell transform a dull-gray metal piece, cast at another facility, into a gleaming, perfectly shaped finished product, measured to an accuracy of a few microns. Every part is numbered, so that it can be tracked throughout its lifetime, and inspected and cleaned multiple times before shipment. I am grateful for this precision and care. Two of these parts -- a ball and a matching socket -- are now my right hip.
In 2007 I saw the doctor for a mild but persistent pain in my thigh. After two months of physical therapy, my hip was so stiff that I could barely bend over. An MRI revealed avascular necrosis, a localized degenerative condition in which an insufficiency of blood causes bone loss and eventually arthritis. Friedrich Boettner, an orthopedic surgeon at New York's Hospital for Special Surgery, informed me ominously that X-rays of my femoral head -- the ball of the hip joint -- showed "signs of collapse," meaning that my hip was too far gone to save. Before the advent of joint replacement, this condition would have meant a lifetime of worsening pain. As it was, within eight months of the diagnosis, I needed a cane and struggled to walk a few city blocks.
A decade earlier, I would have had a total hip replacement, which entails amputating the head and neck of the femur and inserting a stem into what's left of the bone. This is a proven therapy, but it is problematic for younger patients. .......