Patients walking one day after Articular Surface Replacement surgery

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North America’s first Articular Surface Replacement (ASR) surgeries have been conducted at the Jewish General Hospital. In all cases, the patients were able to walk the next day.

The procedure, performed in March by Dr. John Antoniou, an orthopaedic surgeon, is a new alternative for patients who may have once been candidates for a conventional form of total hip replacement.

“This hip resurfacing procedure is ideal for younger patients with more active lifestyles,” said Dr. Antoniou. “The new technology can benefit these patients far more than traditional hip replacement, allowing them the option to be active once again.”

ASR potentially allows the patient to return to previous activity levels, while providing a natural range of motion. With ASR, more of the hip bone is preserved, enabling the patient to retain more natural hip biomechanics and balance.

In this resurfacing procedure, only the diseased portion of the hip socket is removed. The articular surfaces of the femur and acetabulum are replaced and the femoral head is reshaped instead of being removed.

With the ASR, as with all resurfacing procedures, the articulating surfaces (surfaces that rub together) are made of metal, which have a very low-wearing surface. Thus, patients are fitted with an implant that will potentially last longer than a traditional hip replacement.

“We would expect that if everything is perfect, it would last 30 years or more,” said Dr. David Zukor, Chief of the Division of Orthopaedic Surgery, who also performs the procedure with Dr. Olga Huk and Dr. Leonard Rosen.

Likeliest to benefit from this resurfacing procedure are younger individuals who would tend to outlast a traditional hip replacement due to their age and active lifestyles.

And if, at some later date, the ASR patient needs to have the hip revised, the resurfacing implant can easily be converted to a traditional hip replacement. By contrast, if the initial implant is a traditional hip replacement, it might wear out and need to be replaced by an implant in a much more invasive procedure.

Hip resurfacing, on the other hand, allows for maximum preservation of natural bone stock, which would traditionally be lost during a total hip replacement. Hip resurfacing also gives the patient a less invasive long-term outlook, with potential for greater mobility.

While hip resurfacing is not a new concept, it has undergone many changes over the years, especially due to advancements in engineering and materials.

“We’re very excited that such innovative new procedures are being pioneered at the JGH,” said hospital President Stanley K. Plotnick. “It’s a privilege to be among the first to offer this new option to our patients.”

“The Orthopedics Department of the Jewish General Hospital is one of the finest in Quebec,” said Henri Elbaz, Executive Director. “This ground-breaking achievement is a testament to this excellence.”

The ASR is the newest offering from DePuy Orthopaedics and is distributed in Canada by Johnson & Johnson Medical Products. The ASR is unlicensed in Canada and is being managed through Special Access on a patient-by-patient basis.