The increasing number of total hip replacements in young patients in recent years is accompanied by an increased number of revision operations due to excessive wear of the polyethylene in the young active patient, leading to osteolysis and loosening of the prosthesis. For this reason, there has been extensive research to find alternative bearings with better wear properties to cope with this tremendous devastating problem.
At this moment, ceramic-on-ceramic and metal-on-metal resurfacing seem to be the most suitable alternatives for the metal-on-polyethylene bearing in the young active patient.
PATIENT POPULATION
The number of patients suffering from a disabling orthopedic hip problem is continually increasing. In 1998, 13.5 % of patients undergoing a primary or revision hip replacement at our department, were younger than 40 years, 33.4% were younger than 60 years. These numbers are still increasing up to 14.6% and 40% respectively in 1999. Today the mean age in primary hip surgery is 50 years. This has lead to an increased use of alternative bearings such as ceramic -on-ceramic and metal-on-metal resurfacing in hip replacement surgery. The hip joint is essentially a ball and socket joint which allows movements of the hip. A large part of the ball is covered by the socket. This differs from the shoulder joint where only a small part of the ball is covered by the socket. Therefore the hip joint has less range of motion with more stability than the shoulder joint. The hip joint has an important role in weight bearing and allows ambulation. The bone ends of a joint (ball and socket) are covered with a smooth layer called cartilage. Normal cartilage allows nearly frictionless and pain-free movement. However, when the cartilage is damaged or diseased by arthritis, joints become stiff and painful. Osteoarthritis is a degenerative process which directly results in the wearing out of cartilage on the joint surface. Over time, the joint surface slowly erodes, resulting in a painful joint when it moves and bears weight. There might be a fixed position of the hip in flexion. Pain is mostly localized in the groin and/or thigh region (front, inner or outer side) and may refer to the knee as well. There even may be low back pain. Pain is gradually worsening in intensity and duration and becomes finally permanent, even at night. The range of motion of the hip joint becomes really disabling when one is not able anymore to put on socks or knot shoelaces.
Koen De Smet, a hipsurgeon since 18 years has performed 7000 hipreplacements wherefrom 4000 MOM resurfacing procedures and 800 revision surgeries. This vast experience of the surgeon together with his teams in Ghent (Belgium) and in Rome (Italy) has made the ANCA clinic one of the best hip replacement centers in the world. Complication rates are very low, and the postoperative and activity results are very reproducable and excellent.
These results are also often reviewed in peer-reviewed orthopedic studies and articles published.
Patients can by email make a first contact and ask questions. A lot of information can be find on the website.
Costs depend on type of prosthesis, length of stay, work done by the ANCA team for planning.