Dr. Vijay C Bose: Surface Replacement of the Hip Joint

Dr. Vijay C Bose: Surface Replacement of the Hip Joint

What is new in hip resurfacing?

www.hipresurfacingindia.com

Articular Surface Replacement of the hip joint is being performed for over eight years now in India with very good results in young active patients requiring bone conserving replacement of the hip joint.

Resurfacing of the hip joint is only advisable when the shape of femoral head and strength of the bone can support the prosthesis. Healthy active patients in their third or fourth decade who will benefit from a conservative arthroplasty but have poor bone quality in the proximal half of the head of femur are ideally suited for the new prosthesis called Birmingham Mid Head Resection prosthesis (BMHR). With this prosthesis, the fixation of the femoral component depends less on the bone of the femoral head but more on the stem in the healthy part of the head and neck. The femoral medullary cavity is not opened as in the case of modular BHR with a long stem.

Prosthesis:

The BMHR uses the same socket (hydroxyapatite-coated metal uncemented cup) and bearing(metal on metal) as the BHR. The modular head component fits onto a hydroxyapatite proximal porous coated cobalt chrome stem. It is an uncemented short stemmed prosthesis. It was invented by Prof. Dereck Mc.Minn a year ago and is performed by very few surgeons the world over. In India it is being done only at the Asian Regional Center for Hip Resurfacing in Chennai.

Dynamics:

The head of femur is resected just above the head and neck junction. The following dotted line C indicates the level of resection at the head for a Birmingham Mid Head Modular Resection prosthesis. Lines A and B represent the conventional hip resection levels for Total hip replacement and neck sparing total hip replacement, respectively. The resection level for resurfacing is more proximal to line C.

Indications:

The specific type of arthroplasty for a given patient depends on the volume of necrotic segment, patient demographics and activity demands.

1. Extensive avascular necrosis of the femoral head.

2. Developmental dysplasia with shortened head-neck segment.

3. Large cysts of the femoral head.

4. Involution of the head of femur due to severe arthritis.


Advantages:

The BMHR prosthesis due to metal on metal bearing does not wear easily. Patients who have poor residual viable bone can still have the benefits of a near natural hip by using this prosthesis. The BMHR stem offers the advantage of a more physiological proximal loading than the BHR.

References:

Avascular Necrosis in the young Patient: A Triology of Arthroplasty Options. By Derek J.W. McMinn, FRCS; Joseph Daniel, FRCS: Chandra Pradhan 2005.

www.hipresurfacingindia.com

Younger Achiver Award

Dr.Vijay Bose Speech on Jubliee of Apollo Hospital.

Awarded By Sri P.Chidambaram (Hon Union Minister for Finance)

Young Achiver Winning Award - Dr. Vijay Bose.

Apollo Hospitals organised the Doctors' Day Celebrations, in July 2008 the silver Jubliee year of Apollo Hospitals.

Eminent doctors were honoured on this occasion. Dr.Vijay C.Bose was awarded the Young Achiever Award for bringing the trend setting Hip Resurfacing Prosthesis work to our country; touching over a 1000 lives with the first specialised resurfacing center for Birmingham Hip Surgery in Asia.

This was presented by Sri P.Chidambaram, Honorable Union Minister for Finance who was the chief guest of the occassion.

http://www.hipresurfacingindia.com

Reference:

http://www.cbsnews.com/stories/2005/04/21/60minutes main689998_page4.shtml

Medical Tourism - Hip Surgery

(CBS) This summer, millions headed out to foreign lands for vacation, adventure, tourism, or just a beautiful beach.

But how about hip surgery or a multiple bypass or a facelift?

A growing number of tourists are doing just that, combining holidays with health care, and that's because a growing number of countries are offering first-rate medical care at Third-World prices. Many of these medical tourists can't afford health care at home (the 40 million uninsured Americans, for example). Others are going for procedures not covered by their insurance: cosmetic surgery or infertility treatment, for example.

And as Correspondent Bob Simon reported last spring, the hospitals in these faraway countries are glad to have these medical tourists. In fact, they are courting their business, trying to get more people to outsource their own health care.

Thailand is an exotic vacation spot known for its Buddhas, its beaches, its brothels, and the bustle of Bangkok.

But for people needing medical care, it’s known increasingly for Bumrungrad Hospital, a luxurious place that claims to have more foreign patients than any other hospital in the world. It’s like a United Nations of patients here, and they’re cared for by more than 500 doctors, most with international training.

The hospital has state-of-the-art technology, and here’s the clincher: the price. Treatment here costs about one-eighth what it does in the United States. It's the No. 1 international hospital in the world.

"It’s sort of Ground Zero. I haven’t heard anybody yet who’s told us that they take more than 350,000 international patients a year," says Curt Schroeder, CEO of Bumrungrad.

http://www.hipresurfacingindia.com

Reference:

http://www.cbsnews.com/stories/2005/04/21/60minutes/main689998_page4.shtml

Medical Tourism - Hip Resurfacing

(CBS) One patient is Byron Bonnewell, who lives 12,000 miles away in Shreveport, La., where he owns and runs a campground for RVs. A year-and-a-half ago, he had a heart attack, and his doctor told him he really needed bypass surgery.

"They told me I was gonna die," says Bonnewell, who didn't have insurance.

He estimates he would have had to pay over $100,000 out of his own pocket for the operation he needed, a complicated quintuple bypass. And he says he actually decided not to do it: "I guess I figured I'd rather die with a little bit of money in my pocket than live poor."

But Bonnewell says his health was deteriorating quickly, when he read about Bumrungrad Hospital: "I was in my doctor's office one day having some tests done, and there was a copy of Business Week magazine there. And there was an article in Business Week magazine about Bumrungrad Hospital. And I came home and went on the Internet and made an appointment, and away I went to Thailand."

He made that appointment after he learned that the bypass would cost him about $12,000. He chose his cardiologist, Dr. Chad Wanishawad, after reading on the hospital’s Web site that he used to practice at the National Institutes of Health in Maryland.

"Every doctor that I saw there has practiced in the United States," says Bonnewell.

But three days after walking into the hospital, he was on the operating table. Two weeks later, he was home.

How does he feel? "Wonderful. I wish I’d found them sooner," says Bonnewell. "Because I went through a year – I was in bad shape. I couldn’t walk across the room."

How was the nursing? How was the treatment?

"I found it so strange in Thailand, because they were all registered nurses. Being in a hospital in the United States, we see all kinds of orderlies, all kinds of aides, maybe one RN on duty on the whole floor of the hospital," says Bonnewell. "In Thailand, I bet I had eight RNs just on my section of the floor alone. First-class care."

That’s what the hospital prides itself on: its first-class medical care, which it can offer so cheaply because everything is cheaper here, particularly labor and malpractice insurance. You can get just about any kind of treatment, from chemotherapy to plastic surgery.

http://www.hipresurfacingindia.com

Reference:

http://www.cbsnews.com/stories/2005/04/21/60minutes/main689998_page4.shtml

Medical Tourism - Hip Replacement

(CBS) Kim Atwater from Bend, Ore., was on vacation in Thailand when she decided to combine sightseeing with a bit of an eyelift.

Was she nervous about having an operation done in Thailand?

"Yes, yes, I was somewhat hesitant about having any type of operation in a foreign country, and it turned out to be, I mean, it was beyond my expectations," says Atwater.

And it was not beyond her budget: $1,500, and that included a private room.

How would she describe the difference between this place and an American hospital? "It's much nicer than any that I’ve ever stayed in the United States," says Atwater.

The rooms look more like hotel rooms than hospital rooms, and that’s no accident. The idea was to make the whole hospital look like a hotel and a five-star hotel at that. There are boutiques and restaurants to suit every taste and nationality

"Part of the concept was to create an environment when people came in they didn’t feel like they’re in a hospital," says Schroeder. "Because nobody really wants to go to a hospital."

Bonnewell says he's going back this fall for another checkup. He'll have to take a 22-hour flight, but there’s even an upside to that.

"We do have a very unique relationship with Thai Airways," says Schroeder. "So you can buy a ticket. You can use frequent flier mileage to get your checkup."

Whatever it takes to get your business.

"And this is not the only hospital trying to outsource healthcare, is it?" asks Simon.

"My goodness, no. I, we certainly have not gone unnoticed," says Schroeder. "There are hospitals throughout Asia. There are hospitals throughout Asia, throughout India."

http://www.hipresurfacingindia.com

Reference:

http://www.cbsnews.com/stories/2005/04/21/60minutes/main689998_page4.shtml

Hip Resurfacing

(CBS) India wants to become the world leader in medical tourism, and it might just make it. Alongside the familiar images of the country (teeming, dusty streets, and poverty) you can add gleaming new, private hospitals.

The hospital boom in India was fueled by India’s growing middle-class who demanded access to quality health care. Now, the country known for exporting doctors is trying hard to import patients.

The most important player is the Apollo Group, the largest hospital group in India, and the third largest in the world.

Why is it so important to get foreign patients here?

"It makes sense to establish India as sort of a world destination for health care," says Anjali Kapoor Bissell, director of Apollo’s International Patient Office.

But why should foreigners come here? Well, it’s even cheaper than Thailand for most procedures, with prices about 10 percent what they would be in the United States.

Anne Bell works at the British High Commission in New Delhi. She just had a baby and says she’s glad she was here, and not in England: "There’s been no pressure to go home after the delivery. We’ve been welcomed to stay as long as we want. They’re looking after the baby. They’re looking after me, giving me enough time to get settled and get confident enough to go back home. Often in the UK, you might be out of the hospital within five hours if you’ve had a normal delivery."

And in the UK, she wouldn’t have had a private room and a private bath. Not to mention massages, and yoga, too. And the doctors? Indian doctors are known worldwide, they speak English, and they’re often the very same doctors you may have had in Europe or America, where many of them practiced before returning to India.

"Do you find that many Indian doctors are coming back now because of hospitals such as this one?" asks Simon.

"Yes, a large number are coming back," says Bissell. "Because they have something to come back to."

Dr. Praveen Khilnani, a pediatric intensive care specialist, worked at several American Hospitals, including Mass General. Dr. Vikas Kohli is a pediatric cardiologist who worked at hospitals in New York and Miami.

Both need sophisticated equipment to care for their patients, something India didn’t have before the birth of private hospitals like Apollo. They both wanted to come back to India despite the fact that medical care costs much less here, partly because doctors make much less.

"How much less do you make here than in the United States?" asks Simon.

"Maybe a tenth or a twentieth of what we were making the U.S.," says Khilnani.

They wanted to come back, they say, because they felt their expertise was needed here in IndiaAmerica.

"There are probably 1,500 to 2,000 pediatric cardiologists in the U.S. I would be one of them," says Kohli. "In India, there were just four of us. I was very passionate about working for Indian kids."

Since there are so many Indians who require the kind of care that only they can offer, why is there such a strong drive to attract foreign patients?

"Who doesn’t mind extra money flowing in?" says Kohli.

Stephanie Sedlmayr didn’t want to spend the tens of thousands of dollars it would take to get the hip surgery she needed. And she didn’t have insurance, either. So with her daughter by her side, she flew from Vero Beach, Fla., to the Apollo Hospital in Chennai. She’d never been to India

"My doctor, actually, in Vero Beach, she's an Indian doctor. So, why not go where they come from?" asks Sedlmayr, who says her friends questioned her decision. "Hardly anybody said, 'Oh, great idea.'"

But she didn’t just come here to save money; she came for an operation she couldn’t get at home. It’s called hip resurfacing, and it has changed people’s lives.

It hasn’t been approved yet by the FDA, but in India, Dr. Vijay C Bose has performed over 300 of them. He showed 60 Minutes the difference between a Hip Resurfacing and Hip Replacement, which is the standard operation performed in the United States. He says his patients usually recover faster because his procedure is far less radical and doesn’t involve cutting the thighbone.

Instead, Bose fits a metal cap over the end, which fits into a metal socket in the hip. The result, he says, is that patients end up with enough mobility to do virtually anything.

"So my patients, you know, play football, basketball, whatever you want. Not a problem," says Bose.

Until the FDA approves it, the only way to have this operation in the United States is by getting into a clinical trial. But be warned: It isn’t cheap.

How much does it cost in the States?

"I believe it costs something from $28,000 to $32,000 U.S. dollars," says Bose.

And in India, Sedlmayr says it costs $5,800: "Private nurse after surgery. And, feeling always that they were just totally attentive. If you rang the bell next to your bed, whoop, somebody was there immediately."

Sound too good to be true? Don't forget: It’s at least a 20-hour trip, there is malaria in parts of India, patients have complained of intestinal disorders -- and if something goes wrong, you could end up suing for malpractice in an Indian court.

And one could only wish you the best of luck. But Sedlmayr feels she’s already had more luck than she had any right to expect. By the time 60 Minutes left India, she was into the tourism part of her treatment, convalescing at a seaside resort an hour’s drive from the hospital.

"Is this standard, that when somebody gets surgery at the hospital to come to a resort like this afterwards?" asks Simon.

"Yeah, they suggest it. They recommend it," says Sedlmayr. "[It cost] $140 day for myself and my daughter, including an enormous fabulous breakfast that they serve until 10:30."

"I think a lot of people seeing you sitting here and what's usually called post op, and hearing your tales of what the operation was like, are going to start thinking about India," says Simon.

"Yeah, and combining surgery and paradise," says Sedlmayr. much more than in before, but she already knew quite a bit about Indian doctors

http://www.cbsnews.com/stories/2005/04/21/60minutes/main689998_page4.shtml

For Details Contact -:-

Asian Regional Center for Hip esurfacing (ARCH)

Dr. Vijay C. Bose

Consultant Orthopedic Surgeon

Asian Regional Center for Hip Resurfacing

Apollo Specialty Hospital, 320, Mount Road, Chennai - 600035. INDIA.

E-Mail: bose5vijay@hotmail.com

Telephone: 0091-44-(0) 98400 - 32251

or

http://www.hipresurfacingindia.com

Hip_Patients_find_Surgeons_Overseas

Hip patients find surgeons overseas

Delay in FDA approval for Hip Resurfacing means lost opportunity at Duke

Asian Regional Center for Hip esurfacing (ARCH)

Dr. Vijay C. Bose

Consultant Orthopedic Surgeon

Asian Regional Center for Hip Resurfacing

Apollo Specialty Hospital, 320, Mount Road, Chennai - 600035. INDIA.

E-Mail: bose5vijay@hotmail.com

Telephone: 0091-44-(0) 98400 - 32251

or

http://www.hipresurfacingindia.com

Surface Replacement of the Hip Joint.

(http://www.hipresurfacingindia.com/hip-resurfacing.php)

What is Hip Resurfacing Hip resurfacing epitomizes medical achievements in arthroplasty. It is a conservative surgical technique of arthroplasty of the hip. In this the diseased surface of the head of femur is replaced with a cobalt chromium cap retaining all the healthy bone. The lining of the acetabulam is also replaced with the cobalt chromium cup. This mimics the natural hip closely and has near normal biomechanics, load transfer and range of movement at the hip joint. This surgery is performed under General Anaesthesia.

http://www.hipresurfacingindia.com

Hip Resurfacing prosthesis Total Hip Replacement Prosthesis

History of hip resurfacing- (http://www.hipresurfacingindia.com)

Hip Resurfacing Surgery was first performed by Dr.Derek Mc Minn and Dr.Ronan Treacy the inventors of the metal on metal prosthesis at the Royal Orthopeadic Hospital Birmingham in 1996. Hence the procedure went on to be known as the Birmingham Hip Resurfacing or the BHR.

o Birmingham Hip resurfacing was performed in India for the FIRST TIME in 2000 by Dr. Vijay C. Bose at Apollo Specialty hospital Chennai. He underwent training in Birmingham under Dr Treacy and Dr.Mc.Minn. Since then he has performed over 1000 Hip Resurfacing Surgeries at ARCH (Asian Regional Center for Hip Resurfacing). ARCH also boasts of Highest Number of Resurfacing Surgeries done for Avascular Necrosis of head of femur.

o In June 2002 the National Institute of Clinical Excellence (NICE) which is a medical advisory body in the U.K. recommended Metal on Metal Hip Resurfacing for all hip arthritics less than 65 years of age.

o The first Asia-Pacific single theme live Workshop on Metal on Metal hip resurfacing was conducted at Apollo Specialty Hospital in Chennai in March 2003 by Dr. Vijay C. Bose.

o In May 2006 The Birmingham hip resurfacing prosthesis which was now manufactured by Smith and Nephew received the Food and Frug Administration (FDA )approval in the United States of America.

Who needs Hip Resurfacing? (http://www.hipresurfacingindia.com)

Patients suffering from severe primary or secondary arthritis of the hip are advised to undergo hip resurfacing. This is indicated when medicines and other non surgical procedures have failed to control pain. This procedure resurfaces rather than replaces the head of femur. After hip resurfacing, patients are pain free and get back the original range of movement at the hip joint.

The Disease:

Primary osteoarthritis of the hip occurs in the older age group. Secondary Arthritis of the hip occurs in the younger age group and is more common in Asia. Secondary arthritis of the hip can be due to ankylosing spondylitis, rheumatoid arthritis, Avascular necrosis of the head of femur, Hip dysplasias or arthritis secondary to trauma.

Age:

Hip resurfacing can be done on arthritics less than sixty years of age. However patients over sixty with good bone density will also be suitable for hip resurfacing. Patients less than sixty years of age but having osteoporosis, especially female patients are not candidates for the procedure. The youngest patient to have undergone HRS surgery at Apollo Specialty hospital was 12 years old and the oldest was (65)

Activity Level:

Arthritics who would like to got back to a high range of physical activity benefit most from resurfacing.

Advantages of Hip Resurfacing . http://www.hipresurfacingindia.com/

o Relief from chronic pain associated with arthritis of the hip.

o Risk of dislocation is less in resurfacing as compared to replacement as it simulates the normal anatomy of the hip.

o Due to Metal on Metal interface, wearing of the artificial joint is less and usually doesn’t require revision surgery. Hence particularly useful for younger patients.

o Hip resurfacing is a Bone Conserving procedure. Only the diseased surface of the femur is removed hence recovery is faster. Revision arthroplasty if required is easier to perform because of spared bone.

o There is no restriction on personal, professional or recreational activities after this procedure. Unlike the total hip replacement after which patients cannot squat or sit cross-legged on the floor. The young and active benefit tremendously from this surgery.

o Deformities of the hip, shortening of limb and/ or limping due to long standing arthritis are corrected after hip resurfacing surgery.

The Center for Resurfacing - http://www.hipresurfacingindia.com/

The ARCH or the Asian Regional Center for Resurfacing is the First Specialized center for Resurfacing in Asia. Computer Navigated Surgeries are performed in state of the art theaters with laminar air flow. Internal ventilation surgical hoods provide very sterile environment for the implant surgery thus minimizing the chances of infection.

The newly inaugurated Platinum Ward in the hospital has state of art facilities that cater to all the needs of patients in the period of recovery after Hip Surgery.

The center has a team of specialized surgical consultants, anaesthetist, physiotherapists and well trained staff including an international patient’s coordinator.

Computer aided navigation system Surgical hoods.

What to expect from Resurfacing? http://www.hipresurfacingindia.com

Patients have to be admitted one day before surgery or two days before if they are travelling from outside the country. The procedure itself takes two to four hours depending on the extent of the pathology. The hospital stay is usually for five days after the surgery. Patients from overseas recuperate for a week in a resort by the beach. Following surgery, they can walk on crutches by the second day, climb stairs by the fifth day and are back to work by the fifth week.

Linda Pugilese Won the weapons division of Karate National Championship 2007 in U.S.A., one year after both her hips were resurfaced by Dr. Vijay Bose in Chennai.

Trophies for Hip Resurfacing

Dr. William Cory Foulk took part in the 2006 Ironman Triathlon world Championship Ten months after having a Birmingham hip Resurfacing procedure with Dr. Vijay C Bose

For More Details for Hip Resurfacing, Total Hip Problems:-

Dr. Vijay C. Bose – Specialist in Hip Resurfacing

Consultant Orthopedic Surgeon

Asian Regional Center for Hip Resurfacing

Apollo Specialty Hospital, 320, Mount Road, Chennai - 600035. INDIA.

E-Mail: bose5vijay@hotmail.com

Telephone: 0091-44-(0) 98400 - 32251

Visit Us: http://www.hipresurfacingindia.com

Hip Resuracing by "Katharine Greider"

"The Hip Is So Much Better, I Forget About It" By Katharine Greider

For Douglas and Ann Stoda of Tomah, Wis., Paris was the low point.

They weren't on vacation in the City of Light, but trudging through chaotic Charles de Gaulle International Airport on their way to Chennai, India, where Doug was to undergo surgery to repair a hip first injured 13 years earlier in a logging accident. The trip—including the couple's first-ever commercial flight—took well over 20 hours, and Doug was in no shape for it.

Before his hip resurfacing last year, Doug, now 53, had been in so much pain that he couldn't sleep for longer than 90 minutes at a stretch. Aware that his desperation for relief might blur his thinking, he asked Ann to keep her eyes open as they traveled into unfamiliar territory. "I said, 'Ann, if something comes up that is not right, we stop. You use your best judgment here.' " Ann says she cried on the way from the airport to the hospital, overwhelmed by contrasting scenes of opulence and poverty in Chennai (formerly known as Madras), a city nearly the size of New York.

But once they arrived at Apollo Specialty Hospital, they found themselves in the hands of a kindly surgeon named Vijay C. Bose, who visited them daily and put them at ease with quips about Wisconsin cheese. Then Doug recuperated for 11 days at a resort on the glittering Coromandel Coast of the Indian Ocean, with hospital-trained personnel checking in regularly.

Back home, Doug soon found he could work on the industrial line at a local glass factory for 10-hour shifts. This was good news because the Stodas, who were uninsured, faced an $11,500 bill for the surgery and travel—a fraction of the U.S. cost, but still a lot of money.

Today the Stodas are providing the glass company with cleaning services, this time as contractors running their own business. The surgery bill is paid off.

And the hip? "I can jog," says Doug. "I can jump rope. The hip is so much better that I forget about it."

www.hipresurfacingindia.com

Reference:

http://www.aarp.org/bulletin/yourhealth the_hip_is_so_much_better_i_forget_about_it.html

Operation is Conducted in Hip Resurfacing Surgical Center India