More than 193,000 total hip replacements are performed each year in the United States with about 10 percent of those requiring a revision. Now, a technique used on cancer survivors is giving new hope to patients in the most critical situations.
Walking is something Marci Ybarra must work at.
"Every step you take, that's like baby steps to me.," said Ybarra.
After a staph infection 26 years ago ate away her hip cartilage and part of her pelvic bone, doctors told Ybarra she no longer had a hip and faced a long road to recovery.
"I could be laying in my sleep and I'd turn over and my hip would dislocate," said Ybarra. "I'd have to go to the emergency room."
And to the emergency room she went -- 42 times. Then, something happened that no doctor had ever seen before.
"I had a vaginal fistula," said Ybarra. "Nobody's ever had that in the world either. That's where, I don't mean to sound gross, but one of the pins came loose and went through my vagina wall."
Ybarra was then referred to Doctor Henry Finn of the Chicago Center for Orthopedics at Weiss Memorial Hospital.
"Even though I was just a bodily mess, he was my hero," said Ybarra.
Finn treated Ybarra's fistula and ultimately changed her life with a technique he pioneered normally performed on bone cancer survivors. With pins and cement, Finn helps patients like Ybarra who after a dozen hip surgeries, has very little of her own bone left.
"They come from long distances away. They've had multiple revisions, infections and have had massive bone loss and sort of, they are looking for a last hope," said Finn.
Finn compares the procedure to a road project, a project that keeps patients like Ybarra moving.
"When someone is laying a road, they use wire mesh or steel bars to keep the concrete from breaking up, "said Finn. "That same mechanical principal is utilized here to reconstruct this patient's pelvis."
Joint replacement is growing rapidly. Finn said that in five years, 1.5 million hip replacements will be performed each year. Procedures like the pin and cement technique will offer hope to some of those patients who would otherwise run out of options to repair their bodies.
Hip Surgery Hope
Background: Today, more than 193,000 total hip replacements are performed each year in the United States. Other similar surgical procedures are performed on other joints in the body including the knee, shoulder, and elbow. The first hip replacement surgery was performed in 1960. Since then, improvements in joint replacement surgical techniques and technology have greatly increased the effectiveness of a total hip replacement. Osteoarthritis, rheumatoid arthritis, and traumatic arthritis are common causes of hip pain and loss of hip mobility.
(Source: American Academy of Orthopaedic Surgeons)
The Procedure: Patients are usually admitted to the hospital the day of their surgery. The surgery typically takes a few hours. The surgeon removes the damaged cartilage and bone and then positions new metal, plastic or ceramic joint surfaces to restore the alignment and function of the hip. Many types of designs and materials are currently being used for artificial hip joints. They consist of two basic components: the ball component and the socket component.
Revisions: About 10 percent of patients who undergo total hip replacement surgery will need a revision for their implant. "We are seeing patients from 20 and 30 years ago who had their first joint replacement. They either have had a complication such as wear of their bearing or secondary osteolysis and destruction of bone. They may have had an infection. They had the hip removed and replaced multiple times, and each time that occurs, there is loss of bone," Henry Finn, M.D., from the Chicago Center for Orthopedics at Weiss Memorial Hospital and the University of Chicago, told Ivanhoe.
New Help: Dr. Finn has pioneered a pins and cement procedure. It's a technique borrowed from patients with metastatic bone cancer and is now being used on patients who have very little of their own bone left. Dr. Finn used the procedure on a patient with a hip-vaginal fistula who had a dozen hip surgeries. He says this technique offers hope to patients who have run out of options, but it's not for everyone. "This should not be touted as first-line treatment," Dr. Finn told Ivanhoe.
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