Nathaniel Stewart, MD

A New Way to Help Decrease Hip Pain

So you May Get Back to Exercise and the Lifestyle that you Loved

You were fit and healthy, leading a life rich with sport and exercise – walking, biking, swimming, yoga or activities that gave you joy. Then the pain in your hip came. And as it grew steadily worse, what it took away from you became more and more painful. Years before you ever thought it would happen, you are literally on the sidelines. You didn't just inherit a draining and debilitating pain; you lost an essential part of your life. But now you don't have to put up with the pain. The Cormet Hip Resurfacing System, only from Stryker, may help get you back to your normal activities – and let you enjoy them for years to come.

Preserving More of Your Natural Bone

The Inside Story

The first benefit of hip resurfacing is that it's bone conserving – meaning more of your healthy bone is kept intact. The damaged area is simply resurfaced, not fully removed. In this innovative process, the end of the thigh bone (femur) is capped with a metal covering – a strong cobalt chromium metal – much like the capping of a tooth. This fits neatly into a metal cup that sits in the hip socket.

Potential Benefits of Cormet Hip Resurfacing

More Natural Motion and Mobility. Less Chance of Dislocation than Total Hip Replacement *

For a start, keeping more of your natural bone means you can maintain your natural biomechanics. In other words, your natural way of moving. And because large amounts of bone aren't removed, the surgeon can resurface the hip closer to the size and shape of your natural hip.

In fact, your resurfaced femur is almost identical to the size of your natural bone so you get a better fit inside your hipsocket. This may result in greater stability and the potential for an increased range of motion for a more natural hip performance – so you can return to the gym or dancing, or whatever activity you loved.

You are Better Prepared for a Later Treatment

Cormet hip resurfacing removes less of your own bone, which may be important should you ever require a total hip replacement in the future.
Are you a Candidate for Hip Resurfacing?

Hip resurfacing is not for everyone. But the Cormet System offered by Stryker is intended for healthy, younger patients who want to get back to their normal lifestyle. If you are considering hip resurfacing there are other factors that have to be taken into account. Your medical history, fitness level, bone quality, and the progression of the hip disease are a few of the areas that can help determine whether you will be suitable for the hip resurfacing procedure. Even X-rays won't provide all the answers. Only your orthopedic surgeon can advise whether hip resurfacing is right for you.

Hip Resurfacing: Just one of many great Stryker options. You don't have to let pain keep you on the sidelines.

For Hip Resurfacing indications, contraindications and risk information, see the Cormet Patient Labeling.

This material is intended for US distribution only.

Cormet Hip Resurfacing System is manufactured by Corin.
Distributed exclusively by Stryker Orthopaedics in the USA.

Cormet is a registered trademark of Corin PLC.

Reference:

* PMA P050016, Summary of Safety & Effectiveness

Cormet Hip Resurfacing System
Frequently Asked Questions
What is hip resurfacing?

The Cormet Hip Resurfacing System consists of two parts: an acetabular component (or cup), and a femoral resurfacing component (or head).

    * Acetabular component: The cup is used to replace the damaged surface of your hip socket without the use of bone cement for fixation.
    * Femoral resurfacing component: The head is used to cover the femoral head (the ball shaped part of your hip at the top of the thighbone). The head component features a small stem that is inserted into the top of your thighbone. Bone cement is used for fixation of the head to the bone.

The Cormet head swivels within the cup. The surfaces that rub against each other are both made from highly polished metal. This type of hip device, therefore, is called a metal-on-metal hip resurfacing device. All components of the hip resurfacing implants are made of standard materials that have a long history of use in the human body.
How does hip resurfacing compare to Total Hip Replacement?

Resurfacing a hip is similar to a total hip replacement from a surgical perspective. Instead of cutting off the arthritic top of the thighbone (femoral head and neck), the head is reshaped and resurfaced with a metal mushroom-like cap. This is secured in place with a type of bone cement. The hip socket (acetabulum) is prepared in a similar fashion to a total hip replacement. Once the diseased cartilage is removed, a cup is press-fitted into place. Hip resurfacing leaves more of your natural bone in place.
What are the potential benefits of Hip Resurfacing?

Hip resurfacing offers these potential benefits:

    * Bone Conserving: The procedure is bone conserving since the head of the femur is simply reshaped and “resurfaced”, rather than being removed. Patients have more of their natural bone preserved. Should the device need replacing at some time in the future, this may provide better options for the surgeon at that time, as a conventional total hip replacement can typically be used.
    * Reduced dislocation: The large diameter femoral head may reduce the risk of dislocation and often provides a more natural performance than traditional total hip arthroplasty1. Hip resurfacing helps patients resume many of the activities they enjoyed pre-operatively. This makes hip resurfacing an attractive option for younger and active osteoarthritis patients.

Is Hip Resurfacing for everyone?

An orthopedic surgeon can decide if a patient better meets the criteria for a hip resurfacing procedure or a total hip replacement.

Hip resurfacing is most appropriate for young, active patients with:

    * Good bone quality
    * Osteoarthritis

Hip resurfacing is not recommended for patients with the following conditions:

    * Active or suspected infection in or about the hip joint
    * Poor bone quality which may not support the implant
    * Multiple cysts
    * Any known allergy to metal (e.g., jewelry)
    * Extreme overweight (overload on device that would lead to failure)
    * Skeletal immaturity
    * Women in child-bearing years
    * Weak immune system due to disease or certain medications (e.g., corticosteroids)
    * Kidney failure

Your orthopedic surgeon is the only person who can advise you whether you are suitable for hip resurfacing.

What is the right implant for me?

There are many different designs of implants and the choice of implant to be used is at the discretion of the surgeon. Some implant choices are based on surgeon preferences, others relate to the age, lifestyle and clinical condition of the patient. The important thing is to understand what implant or treatment your surgeon recommends and why.

Some patients are not suitable for Hip Resurfacing, usually because their bone quality is not sufficient to support this type of device. However, the benefits of a large-diameter bearing surface can still be provided by using a Stryker total hip implant. In this case, either a metal or ceramic head and advanced polyethylene implants are used. This provides the patient with the same opportunity for lifestyle recovery as a resurfacing implant, but with a femoral stem.

What is the clinical success?

For the vast majority of patients, joint replacement can be extremely successful in providing relief from pain and improved mobility for many years. Hip replacement in particular has become one of the most successful surgical procedures, with a success rate of over 90% in the US.2 The Cormet Hip Resurfacing System has proven clinical experience.1
What are the potential risks and complications?

The usual risks associated with joint replacement apply. There is a low risk of major complications due to infection or early loosening1, which may lead to the need for further surgery. Other possible complications include dislocation, the femoral neck fracturing after surgery, audible noise during motion and allergic reactions. Your surgeon will advise you of any risks involved in your specific procedure.

For Hip Resurfacing indications, contraindications and risk information, see the Cormet Patient Labeling.

What can I expect after the operation?

After surgery you will need to rest your hip to allow proper healing. Your activity will be restricted during this healing period. During the first weeks after surgery, you may be advised to put a pillow between your legs when turning over in bed, wear elastic stockings, use raised toilet seat, take showers rather than baths, restrict activities such as sudden twisting or turning, crossing legs, exposing the scar to sunlight, and driving. Follow carefully your surgeon's instructions regarding progression to normal weight bearing and resumption of normal physical activity. Individual results will vary and all patients will experience different activity levels post-surgery.

Even after the healing period, excessive loads placed on the implants through sudden trauma or high impact activities, such as running and jumping, can damage the artificial joint.

The majority of your therapy and rehabilitation will occur once you are discharged from the hospital. Your physical therapist (PT) should design an exercise program to increase the motion and strength of your hip and should make sure that you know proper form before you begin the program. The rate and effectiveness of your rehabilitation is critically dependent on your commitment to the physical therapy program as well as other clinical factors.

You will be given detailed post-operative instructions by your surgeon before you leave the hospital. If you want specific exercises which will aid your recovery, ask your surgeon or the physiotherapy department at your hospital.
To what extent will my activities be restricted after Hip Resurfacing?

While you are in hospital, you should listen carefully to the advice from your surgeon, physical therapist, or occupational therapist. It is important that you adhere to their instructions and ensure that you comply with any exercise regime that they recommend.

You will certainly need help and support when you return to your home, the amount of support being dependent on your general physical condition and the type of surgery you have had. You may be advised by your surgeon to walk with a cane or crutches for some time after your operation in order to relieve the amount of load on your operated joint.

While joint replacement surgery can provide relief for chronic and debilitating pain, you must remember that it will take some time for your muscles and other joints to recover to a more normal range of movement; therefore it is not realistic to expect an instant return to normal levels of activity.

How long will the implant last?

This will depend on a number of factors, including the extent of your osteoarthritis, your physical condition, weight and your post-operative activity levels. Your doctor will help counsel you about how to best maintain your activities in order to potentially prolong the lifetime of the device.

For Hip Resurfacing indications, contraindications and risk information, see the Cormet Patient Labeling.

This material is intended for US distribution only.

Cormet Hip Resurfacing System is manufactured by Corin.
Distributed exclusively by Stryker Orthopaedics in the USA.

Cormet is a registered trademark of Corin PLC.

References:

1. PMA P050016, Summary of Safety and Effectiveness.
2. Ehealthmd.com, June 2007.