Orthopaedic Advancements Enhance Quality of Life
BRMC Viewpoint Summer 2009

Donna Nettles lived in excruciating pain for two years before finding relief through an innovative hip-resurfacing procedure being performed by orthopaedic surgeon Dr. Tom Knox at Baxter Regional Medical Center.

The same surgery that allowed professional athlete Floyd Landis to return to competitive cycling now allows Nettles to enjoy life without constant pain. An alternative to total hip replacement known as the Birmingham Hip Resurfacing System helped them both.

“I feel like I literally have a new lease on life,” Nettles says. “I was pain-free right away. The day after surgery I could tell a difference.” Her hips were injured more than 30 years ago when she fell from a ladder and ended up in a “splits” position. The injury set her up for painful bone spurs and arthritis that worsened over the years, in addition to a permanent limp.

Although her pain grew progressively worse, it became “excruciating” about three years ago. As caregiver for her husband who was dying of leukemia, she couldn’t take time out for surgery. She continued working as a housekeeper at BRMC, but there were days she could barely keep going.

After her husband died about a year ago, she sought help for her own health issues. Dr. Knox thought she would be a good candidate for the hip resurfacing.

The procedure is recommended for patients under the age of 60. “With older people, their bones are more fragile,” Knox explains. “You have to have good strong bones to carry this.”

During traditional hip-replacement surgery, the head and neck of the femur are removed and replaced with an artificial joint. The hip stem is inserted down the shaft of the femur. Hip resurfacing is less invasive; it requires the removal of only a few centimeters of bone and preserves both the femoral head and neck. A metal cup is then used to cap the joint, similar to a cap for a tooth.

The preservation of the bone’s natural structure and stability has made this surgery the choice for younger adults and for athletes such as Landis. Knox, himself an avid bicyclist, says a friend of his – a doctor and a cyclist – who had this surgery has gone on to bike as many as 500 miles in a weekend.

Knox says resurfaced hips are expected to last longer than a regular lifetime. “We hope this is an once-in-a-lifetime procedure,” he says.

Knox spent two weeks training in Alberta, Canada, to learn this technique. And, working with medical devices company Smith and Nephew, Knox developed a new type of retractor so the procedure can be done through anterolateral (front and to one side) approach, his preferred method.

In the two years he has been using the Birmingham System, Knox has completed more than 30 of the procedures at BRMC, all with positive results. “Everyone who has undergone hip resurfacing has returned to work,” he adds.