Clifton Pavilion at Bristol Zoo November 2008
The Annual Bristol Hip Meeting (sponsored by Smith & Nephew) was held in the Clifton Pavilion at Bristol Zoo. The facilities were perfect for such a meeting with a comfortable lecture theatre and an adjoining function room.
The faculty dinner took place at The Bristol Marriott Royal Hotel, College Green. The hotel provided ideal accommodation and a fine evening meal for the delegates and faculty.
The meeting was chaired by Tony Ward, Ashley Blom and myself. The faculty addressed hip preserving procedures and arthroscopic surgery of the hip, prior to evaluating the critical factors in total hip and resurfacing hip replacements. The different processes which alter metal bearing surfaces were discussed as well as specific design features necessary to improve resurfacing hip replacements. The design features from a clinician’s perspective were noted.
Due to the controversies of metal on metal bearing surfaces, a session was dedicated to “Probing Questions about Resurfacing Arthroplasty” to tease out the optimum patient selection. The differences between the various resurfacing hip replacements available in the market, as well as the biological consequences of metal on metal couples, were also covered in this session.
This ushered in the next session on the alternative solutions to resurfacing the hip, such as the Thrust Plate (one of the original metaphyseal hip replacements), Derek McMinn’s Birmingham Midhead Resection and other neck sparing stem designs.
The bearing surfaces remain an all important factor in any joint replacement. This critical topic was furiously debated, comparing third generation polyethylenes with ceramic on ceramic couples and the new dissimilar bearing surface in the form of ceramic on metal launched to orthopaedic surgeons in Australia in 2008.
I presented on “Squeaking in ceramic on ceramic – is it a concern?”. I identified the well publicised, but relatively uncommon problem worldwide, of squeaking in ceramic on ceramic hip replacements. New composite ceramics have extremely low wear and fracture rates and remain an exceptional bearing surface for total hip replacements.
The serious problem of infection in joint replacement surgery was discussed. Microbiology Consultant in-put was provided at the course to discuss new antimicrobial agents and the best methods of eradicating the bio-film and new bacteria. A further presentation was given on the alternative approach of a one-stage exchange procedure compared with treating the patient in two stages, with radical debridement and removal of the infected prosthesis prior to performing the revision hip replacement at a later date.
The faculty and delegates enjoyed the intense debate and honesty of the presentations and everyone thoroughly enjoyed the annual Bristol Hip Meeting.
I would personally like to thank everyone who participated in this highly academic meeting.
Evert Smith, Tony Ward and Ashley Blom.