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Hip Resurfacing for Young Active People!
Today more and more people are hearing about the benefits of hip resurfacing
over conventional hip replacement. This relatively new technology started
with the invention of the “Birmingham Hip replacement” approximately 15
years ago.
Page Contents - Click Below
Hip resurfacing ensures a faster recovery time than
conventional hip replacement and the patient finds that they can return
to normal life sooner.
Direct Healthcare International fit the Zimmer hip-resurfacing unit. We
believe it is the best and most widely used prosthesis with over 300,000
units successfully fitted.
There are no known instances of a hip-resurfacing unit dislocating.
What is Durom™ Hip Resurfacing
Since 1988 Metasul™ has been successfully used for total hip replacement. Today’s metal on metal technology is the result of over one and a half decades of intense development, research and clinical evaluation. This has formed the foundation for the latest evolutionary development – Durom™ Hip Resurfacing.
Advanced engineering and materials technology coupled with Swiss precision
manufacturing has resulted in this exceptional Hip Resurfacing prosthesis.
Developed for the younger and more active patient, it is designed to provide
high levels of joint stability whilst removing as little bone as possible.
The articulating components are made of Metasul™ alloy ProtasulTM-21 WF,
the first wrought-forged CoCr resurfacing prostheses, which is the same
material used to restore mobility of over 300,000 patients.
Design Detail
In designing the femoral component, many important factors needed to be
considered. Bone conservation, precise positioning and an optimum cementing
technique were of utmost importance. The guide pin, whilst removing less
bone than comparable systems, allows for an ideal physiological transfer
of load, whilst ensuring accurate positioning of the prostheses. The unique
grooves, on the inner side, allow for even pressurisation of cement into
the cancellous bone (a spongy type of bone with a very high surface area
found at the ends of long bones), but avoids a taper effect, providing
additional rotational stability.
Minimal Thickness with Maximum Strength!
The acetabular cup is a flattened hemisphere, offering a greater range
and freedom of movement. With a constant wall thickness of 4 mm throughout
all sizes, thecup maintains an inner diameter as large as possible, whilst
maintaining maximum implant strength and minimum bone resection. A coating
of pure titanium, using a plasma spray under vacuum and static load is
applied to the outer surface. This unique manufacturing method gives a
surface roughness of 20–50 microns with a porosity of at least 25%, shown
in vitro testing to significantly improve primary stability. As shown
in laboratory tensile tests the adhesive strength of the titanium coating
of 66.2–76.5 MPa, significantly exceeding FDA requirements of 22 MPa.
Lower Wear Rate!
The high carbon CoCr alloy is produced by a forging rather than a casting
process. This means that the size of block carbides is up to eight-times
smaller compared to cast CoCr prostheses. The resulting lower surface
roughness subsequently leads to a lower wear rate when compared with cast
CoCr alloys. Co-28Cr-6 Mo-0,2C/ProtasulTM-21 WF (ISO 5832-12): a carbide-containing
and therefore low-wear cobalt chrome alloy was chosen for MetasulTM.
The Key to Successful Resurfacing!
As with almost any joint replacement system, precise and easy-to-use instruments
are key to a success.
In developing of the Durom™ Hip Resurfacing the engineers not only focused
on implant design and material technology but also concentrated on the
surgical procedure, and how to resurface the hip in the best way possible.
As a result, an ingenious method to accurately and precisely position
components was created.
Low wear and greater joint
stability
The large diameter of the Metasul™ ball head offers low wear coupled with
greater joint stability and a high range of motion. This is available
in combination with the extensive range of cemented and un-cemented femoral
implants from Europe’s largest manufacturer of joint prostheses.
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Designed to Outlast a "Conventional"
Hip Prosthesis
The Durom Hip Resurfacing has been specifically designed for use in young
active patients who are likely to outlast a "conventional" hip
prosthesis. Emphasis has been placed on a high quality bearing surface,
preservation of bone stock and durable fixation of the components.
The Metasul bearing surface is a proven low wear, low-friction articulation,
having been implanted in over 300,000 patients since 1988. No other metal-on-metal
bearing has such a track record.
The Durom acetabular and femoral components have been designed to allow
maximum preservation of bone stock. The wall thickness of the acetabular
component is as low as practically possible and the cup subtends an angle
of 165°, similar to the natural acetabulum. These features facilitate
preservation of the acetabular bone stock.
The sophisticated femoral instrumentation permits very accurate positioning
of the femoral component, allowing the smallest possible femoral implant
to be used, which in turn, allows the insertion of the smallest possible
acetabular component, again preserving acetabular bone stock.
The Porolock Ti VPS surface coating of the Durom acetabular component
is vacuum plasma-sprayed pure titanium. This coating is associated with
reliable bone in-growth, ensuring long-term secondary fixation. The carefully
controlled vacuum spraying process results in a very high adhesive strength
between the chrome cobalt substrate and the Porolock Ti VPS coating, reducing
the risk of the generation of titanium 3rd-body-wear particles.
The femoral instruments produce an even cement mantle of approximately
1 mm, reducing the risk of fatigue failure of the bone cement. The recesses
within the femoral component enhance rotational stability of the implant.
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Indications for Hip Resurfacing
Hip resurfacing is most appropriate for physically active patients with good bone quality and adequate femoral and acetabular bone stock. Such patients will generally be under the age of 65. However patients with the following indications are also suitable for hip resurfacing.
Contraindications for Hip Resurfacing
Patients with the following indications are NOT suitable for hip resurfacing.
Planning your Journey
Our staff will assist you in planning your journey. This is especially necessary when undergoing hip and knee surgery to ensure that you return home in comfort.
Once you have Arrived
When you arrived hospital staff will great you and ensure that you are settled in the privacy of your own room in the family B&B unit. You will be asked your dietary preferences and be given a short guide to the hospital and its facilities.
Your Hospital Stay
The next day after the preliminary consultation, your
consultant surgeon will carefully assess your condition and will decide
with you which surgery is best suited. There is a short pre-surgery questionnaire
to complete and it is likely that some investigations will be done at
this stage, such as a blood test and x-rays.
You will be fully briefed on what to expect and how to prepare for your
operation. The surgeon will ensure that you are comfortable and explain
all about your surgery. The anaesthetist will visit you and answer any
questions you may have.
After Surgery
A physiotherapist will visit and instruct you in a program of exercises to assist your restoration to peak physical condition. Within a short while you will be safely on the road to recovery!
Our program offers you the opportunity to swiftly
obtain the corrective surgery you need, taking advantage of the benefit
of our experience and expertise in the field of orthopaedic surgery.
Our orthopaedic surgery program takes you step by step through the procedure;
from your outgoing journey and preparation, through to your physiotherapy
program and aftercare pathway leading to full health and fitness.
Total Hip Replacement and Hip Resurfacing
Day 1 - Arrival + settle in to the hospital’s
family B&B unit
Day 2 – consultation + preoperative xrays
+ blood tests
Day 3 – Admission to hospital bed + surgery
+ possible overnight in ICU
Day 4 – In hospital + first day of physiotherapy
Day 5 - In hospital + physiotherapy
Day 6 - In hospital + physiotherapy
Day 7 - In hospital + physiotherapy
Day 8 - In hospital + physiotherapy
Day 9 - In hospital + physiotherapy
Day 10 - In hospital + physiotherapy
Day 11 - Postoperative check and departure
An additional weeks stay with physiotherapy is
available on request.
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Fully Inclusive Surgery Option
The DHI fully inclusive surgery package includes:
Basic Surgery Option
The DHI basic surgery package includes:
Optional extras available are:
MRSA Infection Control Policy
Our partner hospitals have some of the lowest rates of secondary infection in the world. In order to ensure your safety and the safety of others we ask that you undertake an oral smear test for MRSA.
This Test can normally be either:
What does the Test Involve?
The test is easy, painless and straightforward; a smear sample is taken
from the nose and throat. This sample is then sent to the lab for testing.
What other Precautions can I take?
In Addition if you are undergoing joint replacement surgery please:
Direct Healthcare International Limited would like to thank you for your
understanding and participation in this matter to help us to keep our
partner hospitals infection free.
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Equipped with the latest technology, the hospital
has 197 beds, 40 physicians and over 420 employees, offering the very
best in medical care and surgical procedures.
Each physician is specialist trained in one of the primary medical disciplines:
anaesthesiology, surgery (general and vascular surgery; ear, nose and
- throat; gynaecology and obstetrics; ophthalmology; oral and facial surgery;
orthopaedics and urology), dermatology, internal medicine (primary care,
cardiology, gastroenterology, geriatrics, pulmonology and rheumatology),
pathology, paediatrics, psychiatry and radiology.
The hospital has five operating theatres equipped with the newest technology.
The emergency department and the 8-bed intensive care facility are staffed
24 hours a day with on site resident cover.
Nursing staff is dedicated to providing quality service in patient care.
The Hospital offers extensive physical rehabilitation services in its
modern fully equipped physiotherapy department. It also houses a state-of-the-art
laboratory and a modern radiology department is available on site.
The Hospital places a strong emphasis on cleanliness and the quality of
its food. All meals are prepared on site. A substantial lunch is provided,
followed by a light evening meal - the menu is changed daily. For family
and friends, there is a modern Scandinavian style canteen/café facility
where hot meals are prepared and served daily. The hospital has a laundry
service; a hairdressing salon and massage are available for friends and
family staying there.
During your stay, you will be cared for by a number of physicians, nurses
and allied professionals who feel that it is their responsibility to help
you feel as welcome, content and comfortable as possible.
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Frequently Asked Questions – Orthopaedic Surgery
Do I need a referral from
my doctor?
No, a doctor’s referral is not necessary as we carry out a full clinical
examination; x-rays are taken; as well as blood and urine tests. There
is a consultation with the orthopaedic consultant the day before surgery.
However, it is very helpful to have the support of your GP or doctor.
Direct Healthcare International, where possible, prefer to work with your
doctor or GP. This can only benefit the patient in the long run. Should
your GP or doctor wish to know more about our organisation we would welcome
a contact from them.
Would it help if I brought my MRIs, x-rays, etc
with me?
We undertake our own investigations, high definition x-rays and CT scans.
MRI scans are not necessary, if you already have an MRI and it is less
than 3 months old – by all means bring them with you.
Should I inform the doctor if there is anything
unusual in my medical history?
Yes - this should be declared in the pre-surgery enquiry form, which we
will pass on to the surgeon, it is helpful to mention any major points
again. Download the Pre-Surgery Enquiry Form Here.
Will I have the opportunity to ask questions?
Yes, the surgeon is quite open to questions and will explain everything
in detail.
Can my partner attend the Consultation?
Yes, they are welcome to attend.
Will I need any Aftercare?
Our program is designed to incorporate sufficient physiotherapy thereby
leaving little or no requirement for aftercare. Comparative studies have
shown that our patients are sent home in better condition than those treated
in other facilities such as the NHS, BUPA and Nuffield hospitals.
What condition will I be in when I return home?
With hip & knee replacements, you will be able to walk easily with
the aid of the stick or crutch provided. You should be capable of walking
approximately 150 yards or more before getting tired. Depending on your
physical condition, you may have some anti coagulant injections to take
home with you and some stitches may need to be removed after you return
home.
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Can you tell me more about your facility in Belgium?
Direct Healthcare International Limited work with a number of partner
Hospitals in Belgium, depending on the medical speciality. Our main partner
hospital specialises in hip, knee, spine and general surgery. It has 200
beds, is equipped with the latest technology, carries out surgical procedures
with confidence, and offers the very best medical care and attention.
The hospital staff comprises of 40 physicians and over 420 employees.
Each physician is a specialist trained in one of the primary medical disciplines:
anaesthesiology, general surgery, vascular surgery, ear nose & throat,
gynaecology & obstetrics, oral & facial surgery, orthopaedics,
urology, dermatology, internal medicine, cardiology, gastroenterology,
pulmonology, rheumatology, and radiology. The five operating theatres
are equipped with the newest technology. The accident & emergency
casualty department and the 8-bed intensive care facility are staffed
24 hours a day with on site resident cover. This facility undertakes mainstream
orthopaedics, general surgery, ear nose & throat and dental implant
surgery for Direct Healthcare International Limited.
Nursing staff is dedicated to providing a quality service and effective
patient care at all times giving their full commitment and excellence
in caring for their guests. In addition, the hospital is equipped with
an extensive physical rehabilitation unit; a state-of-the-art laboratory
and a radiology department are all available on site.
The hospital places a strong emphasis on cleanliness and the quality of
its food. All meals are prepared on site and the menu changes daily.
There is a laundry service, a hairdresser and a massage service available
for friends and family staying there.
Can I bring a relative or friend?
Yes, there is an in house modern bed & breakfast facility especially
for friends & family members. We would prefer it if at least one person
accompanies you.
On which days is the surgery undertaken?
Orthopaedic surgery is performed either on a Tuesday or Thursday, general
surgery Wednesday and MRI scans Tuesday. The day before surgery is set-aside
for patients clinical and pre surgical examinations and tests.
How many main orthopaedic procedures are done
at the Hospital per year?
The two consultant surgeons have been operating at this hospital since
1992, performing up to 1000 major procedures per year.
How many people does your organisation treat a
year?
We have been in the healthcare service profession for over five years
and successfully facilitate approximately 1400 treatments a year.
What steps are taken to prevent blood clots (thrombosis)?
The hospital will administer low weight heparin 'B' to prevent thrombosis.
You may also receive some of these drugs to take home with you.
I wish to fly shortly after my surgery is this
safe?
Yes flying even long haul is quite safe; as you are receiving low weight
heparin 'B' to prevent thrombosis there should be less risk than usual.
Will I need a blood transfusion?
For hip surgery, it is less likely that blood will be needed; for knee
surgery, it is quite possible. If you are unable to receive transfusion
for religious reasons a “cell saver” machine is available.
If needed, is this included in price?
Transfusion is included in the price as is the use of the “cell saver”.
What is the blood screening policy?
European policy on filtration and testing of blood is very strict. The
hospital is equipped with its own accredited laboratories. Blood samples
can be screened day or night.
The ICU can locally provide blood-gas analysis and ionography under the
supervision of the central laboratory, which is responsible for quality.
Practical arrangements describe:
Indications for:
Blood units are supplied by the Blood Transfusion Centre, which is regulated
by the Belgian Law dated 5th July 1994, pertaining to blood and derivates
of blood of human origin, in addition, the European guide to “qualification
assurance of blood donation and preparation use” is strictly followed
(edition of 8th January 2002 under code R 9515)
Articles 8 & 4 of the Belgian law state that blood must be screened
for hepatitis B and C, HIV, syphilis and anti HBc antibodies.
What type of anaesthesia is used?
The anaesthetist will discuss the type of anaesthesia used prior to surgery.
If you have a preference, please state this to the anaesthetist or surgeon.
Loco-regional anaesthesia (spinal, epidural or combined) is used when
possible. General anaesthesia can be used alone or in combination with
a loco-regional technique.
Loco-regional
With spinal anaesthesia, a small amount of local anaesthetic is injected
through a small bevel needle into the cerebrospinal fluid surrounding
the spinal cord. This gives a fast and profound anaesthesia in selected
segments of your body.
With epidural anaesthesia, a narrow catheter is placed in the epidural
space for postoperative analgesia.
With combined spinal epidural anaesthesia, after identification of the
epidural space, a spinal needle is advanced into the intrathecal space,
allowing injection of the spinal component. After this an epidural catheter
is left in the epidural space for post-op analgesia.
General
If you are undergoing general anaesthesia, you will be put asleep by IV-medication.
A mask or a breathing tube then gives an anaesthetic gas for maintenance
of anaesthesia.
You will receive pre-medication (a light sedative) before going to the
Theatre. This relaxes you and minimizes the discomfort of the procedures
(IV-line, loco-regional techniques) performed while being awake.
The loco-regional will be administered before the induction of general
anaesthesia (if applicable) for reasons of safety.
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Could you tell me a little more about the intensive
care facilities?
The hospital has a fully functioning 24 - hour accident & emergency
department, paramedics, and fully equipped intensive care unit. Response
time for a doctor to be at bedside day or night is under 2 minutes.
How long will I stay in Intensive care?
Usually, less than 1 day, however, if you have any history of heart problems;
are overweight; or have other risk factors, we may keep you in intensive
care for a longer period. This is a perfectly normal precautionary procedure.
Is there any additional cost associated with this?
Providing the length of stay in intensive care is just a couple of days,
there is no additional cost. Please see the DHI overrun insurance for
details.
What if something goes wrong after I return home?
DHI have a number of aftercare and emergency systems in place should they
be needed. Please remember that these should only be used in the event
of an emergency or urgent need. Patient seeking urgent advice should follow
the steps laid out below. If the patient ‘s condition appears serious
a local GP or accident and emergency hospital should be contacted in the
first instance otherwise:
1) Call DHI (preferably during office hours) if necessary use the 24hr
response emergency phone number.
2) The treating surgeon will be contacted and asked take direct contact
with the patient or their physician.
3) The patient may be asked to attend their GP if this is more practicable
or their local hospital.
4) A doctor can be called to attend at the patients home (UK only) in
the event of any significant problems. The doctor can take a wound swab
which will be tested in our labs, report and if necessary medicate.
5) If the problem appears significant but not an emergency the patient
may need to return to the operating facility for further examination and
treatment.
6) DHI also employs consultant surgeons and labs (within the UK) that
will assist in the event that it is needed.
Please remember that DHI have successfully sent thousands of people for
treatment. No significant or urgent medical problems have occurred. No
patient has ever had a cross infection of any kind in one of our partner
hospitals.
What is the risk of infection?
Our partner hospital has successfully treated hundreds of our patients
with no cases of cross infection. Should a patient be found to have an
infection on arrival, they are isolated and treated accordingly. Should
a case of secondary infection occur, it would manifest itself during the
stay in hospital. Belgium has one of the lowest secondary infection rate
is in Europe. Rates in the UK and Eire continue to remain at alarming
levels. In the USA occurrences are on the increase. As recently as 2006
reports from within the UK and Eire health services, the news media, and
senior consultants indicate that the problem remains acute in most hospitals.
So far, all our clients have remained free of secondary infections.
What make of prosthesis is used?
The surgeon’s prefer to fit Zimmer prosthesis in their opinion Zimmer
is the leading manufacturer as it is the largest and most experienced.
Zimmer’s advanced technical capacity means that they produce some of the
best and most durable prosthesis. DHI’s aim is try to ensure that surgeons
use the best implants available, and one that has been proved for a number
of years. (www.zimmer.com)
What is the expected life of this implant?
Zimmer’s prostheses are extremely durable, under normal conditions they
should last for many years.
When the implant wears out what are my options?
This is called a revision procedure. It costs a little more because the
surgical procedure to remove the old prosthesis is more complex.
I understand that there is cemented as well as cement-less fixation, which
is the surgeon likely to use?
The surgeon prefers to work with cement-less fixation, unless the indications
are for a cemented fixation such as weak bone structure. The reason for
not using cement is that the tough alloy used in the construction of the
prosthesis is both porous and rough (on the outside) where it meets the
bone, this enables the bone to grow and fix itself to the prosthesis (like
the barnacles on the hull of a ship). After a short while, the bone grows
over the prosthesis and the two become firmly fixed together. With cement,
there is a slight chance of the cement breaking down and working loose.
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Could you tell me a little more about the physiotherapy
facilities?
The success of a surgical procedure such as a hip or knee replacement,
a hip resurfacing, or spine surgery, largely depends on rehabilitation.
To achieve the best and fastest results, rehabilitation needs to be started
early, be intensive and task-specific (early standing and walking). A
highly skilled team of 10 physiotherapists and 3 occupational therapists,
under supervision of a medical doctor & specialist in Physical Medicine
and rehabilitation, combines the latest rehabilitation techniques with
an extensive experience and a personal approach. They also instruct you
on the practical and ergonomic issues following these interventions.
A brochure with a pre-surgery exercise program to follow at home, and
all necessary information is provided.
Do you offer accommodation for my carer?
Yes, please enquire for details.
What charges are not included?
Any phone calls made during your hospital stay.
It would be nice to speak to someone who has experienced
using your services, could you please provide a reference that I could
reach by telephone?
Yes, we have many previous patients willing to act as referees. Please
contact and we will provide some details.
I am not very mobile. Can you assist with wheelchairs?
We recommend asking us to arrange wheelchair assistance if you have any
mobility problems. Please ensure that we are informed at the office so
that we can best assist you.
What can I do to prepare for Surgery?
How long is the duration of stay?
Hip replacement – 11 days
Hip resurfacing – 11 days
Hip revisions - 16 days
Where can I arrive and still be picked up by your
chauffeur?
You can arrive at the following places:
Train stations:
Airports:
Seaports:
Can I stay longer if required?
Yes, there is additional stay available. We recommend an additional period
of stay for women over 75, and men over 80, or if there are any mobility
problems. The extra stay includes full physiotherapy and enables the patient
to recover more fully before returning home. Please ask about the cost
of the additional stay.
Curriculum Vitae - Dr Frank De Gendt
| Current Position Orthopaedic Surgeon St Rembert’s Hospital Orthopaedics Department St Rembertlaan 21 Torhout |
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Qualifications and Training
General Medicine - 1979-1986 University of Louvain, Belgium : 6 distinctions
Belgian Order of Medicine 10th July 1986
Orthopaedic Training -1986-1992 Prof. Dr. Boute (Brussels)
Prof. Dr. Ling (Exeter)
Prof. Dr. Farby (Louvain)
Prof. Dr. De Brouwer (Antwerp)
Prof. Dr. F. Mulier (Louvain)
Belgium University of Louvain - University Hospital
St. Etiennekliniek, Brussels
University Hospital, Pellenberg
A. Z. Jan Palfijn Hospital, Antwerp
Heilige Hartkliniek Hospital, Louvain
United Kingdom Royal Devon & Exeter Hospital (trauma
hospital)
Princess Elisabeth Hospital (hip surgery)
Previous and Current Employment
St Rembert’s Hospital - Surgical Experience
Courses and Conferences
Publications
“Treatment of Scoliosis with electro stimulation: a critical analysis”,
Dr. De Gendt
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Related Links
More on Hip Resurfacing &
Related Product Information
Why have Surgery in Belgium?
Orthopaedic Surgery Prices
We can help with your Travel Arrangements
To Book please Contact Us by Phone, E-mail or
Fax
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