As you can see from our Home page there has been a change in the administrative leadership here at the JRI. It was time to elevate Dr. Thomas P. Schmalzried to Medical Director, a post I filled since the inception of JRI in 1991. The Institute is in good hands with Tom. He was an outstanding resident and fellow in my program at UCLA. Following an additional Joint Replacement Fellowship at the MGH he joined the JRI at its inception. There will be many challenges for him and the JRI in the current health care scenario. This move followed the plan we negotiated with St Vincent Medical center two years ago, and it will enable me to focus my time on education, research and my clinical practice.
I end this message with the news that our book on “Hip Resurfacing” has been well received. The book is comprehensive, and it chronicles the development, indications, operative technique, and the results of modern hip resurfacing including complications and methods of prevention as well as disease-specific experience. This volume is published by Elsevier and is available through Amazon.com. Please check the link for more information in regard to my continued enthusiasm for resurfacing with the Conserve® Plus and the latest on the BFH (big femoral head) and note our recent publications. .

Status of Conserve® Plus Hip Resurfacing
Hip resurfacing and the use of a Big Femoral Head, which we have pioneered, have become the main focus of my activities.  While many readers now know that resurfacing qualifies as a less invasive procedure (as far as the femur is concerned because the head and neck are preserved), it is also the most tissue-sparing arthroplasty for the hip. But it is technically demanding. For surgeons without sufficient experience with the resurfacing technique and their patients, a total hip replacement with a Big Femoral Head ( to obviate dislocation) remains an excellent option.

I continue to be delighted with the quality of results achieved with the Conserve® Plus metal-on-metal, hybrid hip resurfacing, with some patients over 12 years.  For those patients with good bone quality, there have been few failures (<2%) from the initiation of our series in 1996.  The recent results of our research have led us to methods enabling us to successfully resurface many patients with risk factors initially thought not to be resurfacable by other surgeons. We have not identified any patient who has had a loosening, or has signs of potential loosening, in over six years, and there have been no patients revised for loosening in the series of hips implanted over the last 6.5 years. This improvement of initial fixation is such that long-term durability is now anticipated with our current technique.  Fortunately our excellent results are now being approached by other experienced surgeons who have validated the fundamental design as well as the technique concepts of the Conserve® Plus System.
In addition, with our efforts to improve fixation continuing each operating day, patients with risk factors, such as cystic degeneration, can be successfully resurfaced. For the first time, our results have shown equal durability of resurfacing in hips with secondary arthritis (Slipped Capital Femoral Epiphysis, Developmental Dysplasia of the Hip, Legg-Calvé-Perthes disease, Rheumatoid Arthritis, or Osteonecrosis) irrespective of age or gender when compared to that of primary osteoarthritis5-8.