Total Hip Replacement Spectrum - Dr.Vijay C Bose


Dr. Vijay C Bose Co - Author


The Brimingham Hip Resurfacing was brought to India for the first time by Dr.Vijay C Bose in the year 2000 at the Apollo Speciality Hospital, India.(Since then the Hip Surgery unit was instituted at this hospital.) This unit attracts patients from all over the world for complex hip surgeries and cutting edge technologies in this field.More than 1,400 hip resurfacing surgeries have been performed till date by Author.Hip Resurfacing surgeries has proven to be a boon for young and active with hip arthritis and this technique has enabled many patients to resume a very normal life without any restrictions post-op. However good bone stock in the hip is a pre-requisite for this life changing surgery.

BMHR Implants

The Brimingham Mid-Head Resurfacing(BMHR,Smith & Nephew Orthopaedics,Warwick,United Kingdom) device was developed as an alternative for patients in whom the qualityof bone in the femoral head was unsuitable for hip resurfacing. The BMHR device consists of an uncemented cobalt-chrome metal-on-metal bearing identical to the Brimingham Hip Resurfacing(BHR,smith & Nephew Orthopaedics,Warwick,United Kingdom) device.Proximally the stem is conical in shape with a porous hydroxyapatite coated surface on the outside.


We routinely expose the hip by the Neck Capsule Preserving Approach which is a modification of the posterior approach. We start bt templating the neck of the femur to determine the minimum size of the femoral component that the femur can accommodate. This also sets the minimum size of the acetabular component. Acetabular preparation is done independent of the femoral component. The femoral head is then prepared to receive the BHR device. We then apply a set of criteria to help us decide on the direction to proceed. There must be an intact head-neck junction rim to at least half the profile cut as to enable the femoral component to capture on to the femoral head. In the presence of defects we perform judicious over-resection of the zenith cut to reduce the volume of the defect.


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