Surgeons cautious on hip surfacing technique

By Kim Dixon

SAN DIEGO (Reuters) - A relatively new technique to repair hips got a cautious reception at an annual meeting of U.S. orthopedic surgeons on Wednesday, with many doctors skeptical that the technology is ready for widespread use.

Britain's Smith & Nephew is the only approved maker in the United States of an implant for the technique known as hip resurfacing. Its Birmingham implant replaces the hip joint with a metal ball and cup.

Surgeons conserve bone by cutting away a tiny amount of the top of femur (thin bone), versus a traditional total hip replacement.

The field is likely to get more crowded soon as British rival Corin Group readies for a U.S. Food and Drug Administration advisory panel meeting on its device on February 22.

"I think it's fair to say there was skepticism" about the new technique among a panel of nine top orthopedic surgeons, Daniel Berry, chairman of the department of orthopedic surgery at the Mayo Clinic said.

"Most of the panelists" felt the early failure rate is likely worse than with traditional hip replacement, Berry said.

Potential downsides of the new procedure include increased blood loss, high cost and the need for a larger incision, noted panelist Harry Rubash, a surgeon at Massachusetts General Hospital.

Other companies hoping to win U.S. approval for hip resurfacing including Wright Medical Group Inc. with its Conserve Plus device.

Thomas Schmalzried of the Joint Replacement Institute in Los Angeles said the technology may be superior for a select sub-group of patients. He said a newer version of the technique, with metal on metal bearings, make if better for some patients, including those who are younger and have strong bones.

The primary patients deemed not suitable for the procedure are those with low bone density, which explains why women are less suited for it.

Schmalzried, who is involved in developing Wright's product, noted that 10 years of clinical experience in research settings and outside the United States show the procedure has merit.

He did note that women and patients over the age of 65 are at substantially greater risk with the procedure.

Massachusetts General surgeon Rubash cautioned against rushing to the surfacing procedure. "It's really not ready for widespread use. Be careful when you jump onto the latest fad," he said.

The annual meeting of the American Academy of Orthopaedic Surgeons is taking place this week in San Diego.