The Birmingham Hip:
A New Option for the Younger Patient

The BHR implant component

There is a perception that hip replacement surgery is for the elderly, but that is no longer the case. There are a growing number of physically active patients under the age of 60 who suffer from hip arthritis and other degenerative joint diseases. Fortunately, there is now a clinically proven alternative to hip replacement called BIRMINGHAM HIP Resurfacing (BHR) System.

The BHR System is an exciting surgical option to hip replacement that has recently been approved by the Food and Drug Administration for use in the United States. The procedure is now available in southeast Florida thanks to the efforts of Harvey Montijo, MD, of the Center for Bone and Joint Surgery of the Palm Beaches, who received training in the BHR procedure in England from the surgeon who developed the system.

How the Hip Joint Works
The hip is a ball-and-socket joint. In a healthy hip, the ball-end of the femur swivels smoothly in the socket of the pelvis. In an unhealthy hip, the femur and the socket of the pelvis may become rough and worn. The bones of the joint rub together and may cause pain, swelling and stiffness.

With the BIRMINGHAM HIP, the joint's surfaces are covered with an all-metal implant that more closely resembles a tooth cap than a hip implant. PHOTOS COURTESY OF SMITH & NEPHEW.

BHR Hip Resurfacing
The BHR System simply shaves a few centimeters of the damaged bone surface within the hip joint. A metal cap is fit over the top of the resurfaced femoral ball -- similar to a metal crown being fitted over a resurfaced tooth. A metal cup is fi tted into the pelvic socket. The resurfaced metal-on-metal hip joint glides with a smooth, natural motion.

Benefits
The BHR System offers these benefi ts to the younger, active patient:

• The bone-conserving approach of the BIRMINGHAM HIP resurfaces only a few centimeters of the head of the femur bone while the rest of the thighbone is left completely intact so there is a greater likelihood of maintaining accurate leg length.
• The BHR Implant closely matches the size of the natural femoral head which may translate to greater stability and may decrease the chance of dislocation following surgery.
• The metal-on-metal BHR implant significantly reduces wear. This is especially important considering the hip joint surfaces move against each other at a rate of 2 million footsteps per year in a physically active adult.

"Total hip replacement offers excellent results, especially for elderly people who don't participate in a lot of athletic activity," says Dr. Montijo. "When you start putting standard total hip replacements in people who are very active, particularly in a younger population, you start seeing problems."

About one year following the BHR surgery, patients are often able to return to their active lifestyles, which may include jogging or playing singles tennis. However, during the fi rst year, more conservative, low-impact activities such as walking, swimming and bicycling are recommended for strengthening the joint.

For more information, please call the Center for Bone and Joint Surgery of the Palm Beaches at 561-803-8400 or 561-803-8520.

Harvey Montijo, MD, is a board-certified orthopedic surgeon. He is the senior partner of the Center for Bone and Joint Surgery of the Palm Beaches with extensive experience in knee and hip replacement. For an appointment, please call 561-803-8400.

Enrique Palmer, MD, is a board-certified orthopedic surgeon and associate of the Center for Bone and Joint Surgery of the Palm Beaches offering years of experience in knee, hip and shoulder replacement. For an appointment, please call 561-803-8520. The Center for Bone and Joint Surgery of the Palm Beaches is located at the Palms Wellington Surgery Center on State Road 7/441 in Royal Palm Beach.

Wellington Regional Medical Center, 10101 Forest Hill Blvd. Wellington, FL 33414 (561) 798-8500