A NOVEL TECHNIQUE IN REDUCING BONE DEBRIS IN HIP RESURFACING PROCEDURES

Abstract

Introduction: As a result of the rapid increase in the number of hip resurfacing procedures performed, previously recognized complications have begun to recur; including, femoral neck fracture and heterotopic ossification. Hip resurfacing entails reaming of the femoral head to the appropriate size and significant bone debris produced, usually dispersed in the soft tissues. We advocate the use of a novel technique whereby the bone debris produced is collected and removed effectively without soft tissue spillage and ultimately reducing the incidence of heterotopic ossification.

Materials and Methods: A 60-ml. plastic ‘galli pot’ is prepared by cutting the floor of the container, leaving behind a rim for collecting the bone debris. The container is placed over the femoral head and across the femoral neck. The femoral reamer is applied onto the femoral head with the container in-situ and reaming commenced. The bone debris produced is collected in the container, which is removed after completing the reaming process.

Results: This technique was used effectively on patients undergoing hip resurfacing procedures using the Cormet hip (Corin Medical, Cirencester, UK) and the Birmingham Hip Resurfacing (Midland Medical Technologies, Birmingham, UK). The technique proved successful in collecting the bone debris produced and reducing bone debris in surrounding soft tissues

Discussion: Heterotopic ossification (HO) post hip arthroplasty is a relatively common phenomenon with clinical significance in approximately 5% of all cases. Moderate to severe HO, can negate the benefits of replacement surgery and reducing bone debris has been shown to reduce the incidence of HO and a more favorable outcome. We propose this technique as a method to reduce bone debris spillage in surrounding tissues whilst performing hip resurfacing procedures