Dr. Jacobs has been a world leader in the area of metal on metal research and hip resurfacing technology for the past 10 years. He presented some of the first data on the proper dimensions and clearances for the designs of metal on metal bearings at the Association of Hip and Knee Surgeons in 1996. (invited talks and panels 31 and 32). Beginning in 1997 he directed the FDA study group that led to the eventual FDA clearance of the Johnson and Johnson/DePuy metal on metal total hip system. He has been part of the Corin hip resurfacing study for over 5 years. During that time he has performed over 100 resurfacings and has only one failure over the entire experience. This failure rate surpasses the results of any other center. It is notable that the one percent failure rate includes each and every case from the beginning of the study. Other centers have reported failure rates as high as 20% on the first 50 cases (Mont et al paper 410 AAOS Washington DC 2005). Dr. Jacobs' success and absence of a "learning curve" reflects his deep understanding of the principles of hip surgery and hip resurfacing. It also demonstrates his understanding of proper patient selection so that patients who are poor candidates for the procedure are not subjected to an operation that is likely to fail. Presently he is participating in the Biomet ReCap study as well as the Corin study.
Hip resurfacing is an old concept that has been rediscovered with the advent of newer metal on metal bearing surfaces. The actual concept dates back to the 1960's. The failure rate of those cases was unacceptable for a number of reasons. Most importantly, the mechanical properties of high density polyethylene were such that it could not support the stresses that were required for a successful socket. As a result, the resurfacing concept was essentially abandoned until the 1990's when the potential of metal on metal bearing couples was appreciated. In addition to the development of more technologically sound implants, the procedure itself is technically demanding. The exposure is complicated by the fact that the femoral head is not removed. This makes exposure of the acetabulum significantly more difficult. On the femoral side, it is critical to the success of the operation that the femoral component be positioned properly. The most common cause of failure is related to improper positioning of the femoral cap. Proper patient selection is also a key element to outstanding results. Because of the recapping nature of the device, patients with significant amount of deformity of their hips may not be candidates for the procedure. Similarly, patients with soft bones or osteoporosis may not be suitable for resurfacing. That is because the bone under the femoral cap may not be strong enough to support the implant. Patients with additional questions concerning hip resurfacing are invited to contact Dr. Jacobs' office and ask to speak to Debbie Carey who is the Research Coordinator.