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Weekly News, Analysis, and Commentary

Large Joints Features & News

Su v. Lombardi: Yay or Nay to Metal-on-Metal Surface Replacement?

Image created by RRY Publications, LLC
Image created by RRY Publications, LLC

“Surface replacement trumps THR because it preserves bone, offers greater stability, and allows a higher activity level,” advocates Ed Su. “Keep in mind,” says Adolph Lombardi, “resurfacing is a more difficult operation with a high learning curve. Few patients meet the criteria…and there is concern over metal ion toxicity.”

Lee Debates Barrack: Ceramic-Ceramic THA

Image created by RRY Publications, LLC
Image created by RRY Publications, LLC

“Ceramic-ceramic hips have a place in young, active patients,” advocates Gwo-Chin Lee. “And they have the lowest wear rate.” Robert Barrack counters, “The new ceramics are better, but standard metal-crosslinked poly has improved more. And the 10-15 year results cannot be improved upon. Ceramic-ceramic isn’t ready for prime time.”

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Hofmann, Callaghan Debate the Posterior Stabilized Knee

Image created by RRY Publications, LLC
Image created by RRY Publications, LLC

“I haven’t saved a cruciate ligament in the last five years. It’s more difficult and less predictable. It’s more forgiving to take the PCL,” argues Aaron Hofmann. “A recent study found that ROM was better with the posterior stabilization,” counters John Callaghan. “And Chit Ranawat has had a 95% satisfaction rate with a PS knee…no revisions at 10 years.”

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Dunbar, Cameron Debate Modular Necks

Image created by RRY Publications, LLC
Image created by RRY Publications, LLC

“No modular necks for routine primary hip arthroplasty!” argues Michael Dunbar. “We have no proof of superiority and there is an increased risk of fracture and fretting, ion debris, etc.” Hugh Cameron counters, “Look, I’ve done more than 350 cases with no incidents of delayed metal hypersensitivity and no pseudotumors.”