1. Dr. Pete Rose Joint Replacement

3. Total = Ball + Socket

4. Ball/Socket Replacement

5. CHARNLEY THA: 30 YEAR MINIMUM F/U Results CP1046688-1 Years since THA Survival free (%) 30 Year Survivorship Free of Any Component Removal or Revision For Any Reason: 81.4%

6. Specific Issues in Hip Surgery for Younger Patients “Minimally Invasive Surgery” Resurfacing Operations Bearing Surfaces

7. M.I.S. Surgery Marketing rather than a scientific term Effort to perform joint surgery through smaller incisions –Goal of speeding patient recovery

8. My Advice – Proceed with Caution You’re in this for the 20 year rather than the 20 day outcome –Very subtle differences in artificial hip and knee alignment have a big impact in how long they last –Scientific studies of MIS surgery have shown less predictable alignment than standard surgery –Equal or greater damage to underlying muscles –Computer assistance may erase this difference

9. Resurfacing Operations vs

10. Resurfacing Potential Benefits –More normal loading of the femur bone –Less bone resected –Easier revision surgery –Less dislocation Reasonable option if no deformity present

11. Bearing Surfaces Total hips are mechanical ball in socket joints –Wear debris leads to losening and failure

12. Bearing Surfaces Highly Cross- Linked PE Versatile Versatile Small heads Small heads Wear Wear Dislocation Dislocation Metal on metal Less wear Less wear  Head diameter  Head diameter Ions Ions Women Women Young Young Allergy Allergy Ceramic on ceramic Less wear Less wear Limited options Limited options Inserts Inserts Neck Neck Fracture Fracture Squeaking Squeaking

13. Joint Replacements Important points to remember -Joint replacements (arthroplasty) treat arthritis well -Not a predictable treatment for weakness or motion