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Novel hip resurfacing implant may give higher quality of life, greater mobility to patients

From News Medical - February 7, 2018

Surgeons are treating patients with a new type of hip implant that could lead to better outcomes for younger, more active people requiring surgery.

Fifteen patients have so far been treated with a novel ceramic hip resurfacing implant in a new trial at Imperial College London. Early results suggest patients can return to physical activities such as swimming and cycling within six weeks of their operation.

The investigation, whose lead site is Charing Cross Hospital, part of Imperial College Healthcare NHS Trust, is the first in the world to resurface patients' hips without using metal implants.

The clinical trial is designed to show that the ceramic implant is suitable for both men and women, as conventional hip resurfacing techniques are currently unsuitable for female patients,

The team hopes that the results of the investigation will lead to more treatment options for patients who require surgical replacement of a hip, and enable them to lead fuller, more active lives.

They suggest that the new device, called 'H1', could also reduce the risks of hip surgery, as well as save the NHS 10m a year. The technique may also give patients a higher quality of life than conventional hip replacement surgery.

Every year around 100,000 people undergo primary hip replacements in the UK, at an estimated cost of 600 million per year. Most patients have a total hip replacement (THR) where a damaged hip joint is completely replaced with an artificial one. This is typically carried out on people between the ages of 60 and 80. However, this procedure has been reported to fail in younger patients with more active lifestyles -the stiff metal stem in the thigh bone can cause trouble.

There is an alternative type of surgery known as hip resurfacing, which is carried out on younger patients. Unlike THR, the surgeon only removes the diseased cartilage of the hip joint and resurfaces the joint - until now with a metal-on-metal implant. This approach is less invasive and leaves the patient with greater mobility after surgery.

More of the bone is left in the hip joint, so the patient feels more normal, and can be more active. For young active patients, metal hip resurfacing already lasts longer than total hip replacement. However, in some patients, metal particles are released by the implant, causing tissue reactions around this such as swelling and soreness. This can lead to resurfacing implants failing and patients requiring further surgery.

Furthermore, women are unable to have hip resurfacing surgery, as the metal implant does not fit their hips bones properly leading to higher failure rates. As a result, women ca not have this surgery and their only option is a total hip replacement, whatever their age.

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