Man Undergoes New Hip Resurfacing Procedure

No way was Rick Jones going to be a couch potato. An athlete and youth coach who works out regularly, Jones dreams of someday hiking the Grand Canyon. A painful, arthritic hip started to slow him down, but at 52, he refused. Then he heard about a new surgical hip procedure that could restore his active lifestyle.

The procedure, using something called the Birmingham hip resurfacing system, won federal approval in May as an alternative to the total hip replacement for suitable candidates.

Last week, Jones, of Belleville, Ill., became the first person in the U.S. to have the system implanted. Nine days after his surgery, he's already walking a quarter-mile assisted by a crutch.

"My hopes are I'll be able to get back to running and playing tennis and racquetball and the kind of activities that require agility, speed and mobility that I used to have," Jones said.

Dr. Robert Barrack, an orthopedic surgeon at Barnes-Jewish Hospital in St. Louis, performed the surgery with the help of one of two British doctors who developed the system nine years ago.

It has been implanted in more than 60,000 patients in 26 countries, but until last week, never before in the U.S.

In total hip replacement surgery, which is still recommended for older patients, the top of the femur or thighbone is removed and replaced with a ball and stem. Over time, the stem tends to cause more bone loss and dislocations can occur as much as 5 percent of the time. That limits certain activities.

Such patients are usually advised to avoid yoga, aerobics or running, for example, or else they'd risk dislocation or early loosening, Barrack said.

But with this system, worn-out hip joints are resurfaced rather than completely replaced.

Some cartilage and only 10 percent of bone on the head of the femur is removed, the rest covered with a metal surface. The result is a more stable joint, with a risk of dislocation 10 times lower than with a total hip replacement. Patients also don't lose bone over time, and are at lower risk of fracture or weakening of the bone.

Barrack cautions that only 10 percent to 20 percent of patients are candidates for the Birmingham hip resurfacing system.

"You need good bone density to begin with, which eliminates older women for instance," he said.

Also not recommended for the procedure are patients with shortened legs or deformed hips from cartilage loss or arthritis.

"But for someone younger, who doesn't have a lot of deformity or leg shortening ... and who wants to return to an active lifestyle, this is the thing for them," Barrack said.

Barrack assisted with British surgeons to see the procedure for himself and gain experience.

He said it's the fastest-growing hip operation in Australia and Europe.

Since the St. Louis surgery on June 5, about 20 more U.S. patients have had the procedure.

Washington University School of Medicine, which is affiliated with Barnes-Jewish Hospital, will help collect data from the first 500 U.S. patients to have the procedure to spot and eliminate complications.

Jones, who learned of the procedure in January, said he was willing to wait for FDA approval as long as he had to. "Long term," he said, "it's so much better."

In 2003, the most recent year for which data were available, 325,000 people in the U.S. had either a partial or total hip replacement, according to the American Academy of Orthopedic Surgeons.

As the U.S. population ages, the number of such procedures is expected to increase by as much as 80 percent in the next 25 years.