Patient Success Story - Tony Niel's Total Hip Replacement Surgery in San Francisco
As a 41-year old Santa Rosa fireman and father of two active young boys, Tony Niel was used to waking up every morning with a few aches and pains.
But two years ago, while moving some heavy equipment at work, Tony felt what he thought was a groin pull. The pain came and went for several months and his physician at Kaiser prescribed Ibuprofen for the pain, thinking it was a simple pull. After five months of taking 1600 mg of Ibuprofen daily yet still in agonizing pain, Niel decided something more serious must be wrong. X-rays at Kaiser showed he needed a new hip – something he had a hard time wrapping his head around, considering his age. Dark thoughts ran through his head about having to quit the job he loved so much…and not being able to run and tumble and play with his sons.
Niel turned to the internet to learn more. He found a website that talked about world-renown cyclist Floyd Landis – and the hip resurfacing procedure he underwent. Further research taught him about that procedure, called Birmingham Hip Resurfacing (BHR), an implant that is an alternative to total hip replacement that may last longer and enable a more active lifestyle than traditional total hip implants. To resume his active lifestyle was exactly what he wanted and, he figured, if BHR was good enough for Floyd Landis, it was good enough for him!
Additional research found that only a handful of Northern California physicians specialize in the BHR procedure and Niel choose Christopher Cox, M.D. of California Pacific Orthopedics and Sports Medicine. Three years ago, Cox spent a week in Birmingham, England training with the inventor of the BHR, Derek McMinn, M.D. He has since performed over 100 BHR procedures successfully – not to mention the more than 2500 traditional hip replacements he has performed throughout his 17-year career.
Of course, not every patient is a good candidate for BHR. In general, men under 60 years of age and women under 55 receive the most benefit, particularly because in another 25 or so years they will most likely need another hip replacement procedure and the BHR leaves them with more intact bone. With the BHR, bone density actually increases over time.
Current data shows that 10 years after surgery, 95.4% of the BHR hips studied are still performing as designed. And according to the definitive Australian Orthopaedic Society’s registry of patients, hip resurfacing procedures actually last longer than total hip replacement in male patients under the age of 65.
The Birmingham Hip implant is intended for patients suffering from hip pain due to osteoarthritis, dysplasia or avascular necrosis, and for whom total hip replacement may not be appropriate due to their increased level of physical activity. The BHR hip may not be appropriate for people with impaired kidney function or for women who are or may become pregnant.
The day after his surgery at California Pacific Medical Center in San Francisco, Niel was up walking with his occupational therapist – assisted at first by a walker and then by crutches. The next day, his therapist had him walking up a flight of stairs. Within two weeks, he was doing aquatic therapy while recuperating at home. After six months, Niel went back to work, where he was put on light duty for two weeks. As soon as he went back to regular duty, he was put to the test – with house and car fires to fight. While he was initially worried about how the heat of those fires would affect the metal implant, he soon realized that his new hip was actually stronger than his other hip. His co-workers even joked that he was the “Bionic Man” with his new hip!
Advantages of Birmingham Hip Resurfacing (BHR) Hip Surgery
While hip resurfacing is not new – it’s been around since the 1930’s – what has changed with the BHR (Birmingham Hip Resurfacing) are the materials:
- The metal-on-metal provides low-wear high-strength bearing
- The femoral component is not porous ingrowth
- The femoral head is cemented and vented during preparation
- The cup is hydroxyapatite coated to stimulate bone ingrowth
- The cup is solid and cannot accept screw fixation
- The fins provide rotational stability
- The Acetabulum is not super-heated as the porous coating is not sintered
- The heat of sintering drives bulk carbides away from the surface; by eliminating this, excellent joint wear characteristics are maintained
BHR implants have been performed at CPMC since 2006 by physicians who trained in England with the inventor of the device, Derek McMinn, M.D. The success rate of those physicians, Drs. Christopher Cox, Peter Callander and Robert Gilbert, speaks for itself:
- Complications: 1 deep infection
- Intra-operative failures: 2 (not included in total)
- No dislocations
- No femoral neck fractures
- Decreased length of stay
- Lower blood loss (age, no IM canal)
- No drains required
For More Information
The Joint Replacement Center at California Pacific Medical Center is a branch of the Department of Orthopedic Surgery, which provides specialized services for treating conditions of the knee, hip, shoulder, elbow, foot, and ankle.
We offer access to break-through treatment, and advances in technology to patients requiring total joint replacement of the hip, knee or shoulder. Our surgeons have deep expertise in leading-edge treatments and work closely with a multidisciplinary team, providing care in rehabilitation medicine and physiatry, as well as physical therapy and occupational therapy.
Our goal is to return function for our patients and to improve their quality of life. We are committed to utilizing the vast array of resources available at California Pacific to provide personalized treatment and a full continuum of care for each patient.
To find out more, call us at 888-637-2762.
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