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8          Constantiaberg Bulletin      Thursday October 22 2009                      NEWS


	Latest orthopaedic technology goes live

Constantia orthopaedic surgeon Leith Stewart demonstrated the latest technology of arthroplasty (literally “surgical repair of joint”) for specialists from around the country. Bulletin reporter KAREN WATKINS was there to watch.

This new technology demonstrated by expert Australian orthopaedic surgeon Michael Solomon, originally from South Africa, results in a longer lifespan of the original hip.
The demonstration was an educational session for visiting surgeons and professors from tertiary institutions and other teaching hospitals.
Dr Stewart practises at Life Kingsbury and Claremont Hospitals and has been performing the Birmingham

Hip Resurfacing (BHR) procedure for nine years.
    Under the knife was a 59-year old female “gym junky” from Tokai who was described as having difficulty dressing but with good bone-density, making her an ideal candidate for the procedure.
    There is no such thing as keyhole surgery when it comes to a hip replacement or this new technique, called Birmingham Mid Head (BMHR)
and the skin cut is about 20cm.           However, the procedure has been described as one of the most successful operations of the century.    A major advantage is that patients are up and on crutches within two days, instead of six weeks if a total hip replacement is done.
Infection is the biggest danger but Dr Stewart boasts that Life Claremont has the lowest infection rate.
At 1:28pm the assembled specialists were talked through the procedure.


	■ Expert Australian orthopaedic surgeon Michael Solomon demonstrated the latest technology of hip resurfacing last week for specialists from around the country.


		He had a BHR performed on his left hip about seven years ago, with great success, so it is no wonder that his passionate about it The patient had been draped and prepared before the incision and the hip joint deftly dislocated. The first part of the operation was to fit the cap of the prosthesis, accompanied by hammering and drilling. Insertion of the pin and modular head was the most time consuming, measuring and drilling away the trashed bone. By 2:16pm it had been fitted without the need for cement. The final step was stitching, a lengthy process taking 15 minutes. Total hip replacements have been used successfully for 50 years, yielding good results in elderly inactive people. But they have been less successful in young and active people who respond better to resurfacing of BHR. The procedure was developed in 1997 as a bone conserving alternative to total hip replacement by orthopaedic


	surgeon Derek McMinn of Birmingham and a team of engineers. Hip resurfacing arthroplasty covers the two surfaces of the hip joint, replacing the cartilage which covers the surfaces of the ball at the end of the thigh bone (femur) and the cup-shaped cavity (acetabulum). The joint is fitted with an anatomically shaped metal sphere which has a spike in it that penetrates the head of the femur. This prosthesis is highly engineered and made with cobalt chrome, longer lasting than a plastic cup used in a total hip replacement. However, not every patient is a suitable candidate for a BHR. The new technique has a thicker stem which only goes into the neck of the femur, as opposed to a long pin in a full hip replacement. However, BMHR can only be used when the bone quality is good. Dr Stewart, an avid cyclist and snowboarder and former Springbok hockey player, has been performing the procedure for nine years.

		■ Dr Leith Stewart feels that this new prosthesis could take over from the previous one.