Bone marrow

Bone marrow and its importance with a hip operation: yet an advantage with hip resurfacing!

In 2006 I started to study the subjects “hip prostheses” and “hip resurfacing” since I would need a prosthesis myself and was interested in resurfacing (which I ultimately also got). One of several points that surprised was the fact that other people with hip problems in contact with me never reported that their surgeons had touched the subject “bone marrow” and what the implications are for the body if bone marrow is removed from the leg. I regard this a miss by the surgeons, certainly with patients that will receive a THR (conventional hip prosthesis) it should be told that some or sometimes all the marrow will be removed from the thighbone. Unfortunately the Swedish orthopedic surgeons use in about 99% of all hip operations a conventional hip prosthesis with a shaft for which it is required to remove and sacrifice the femoral neck of the leg plus removal of some or all of the bone marrow from the femoral canal (one of the largest stores of marrow in the body). Removal of the marrow from the thighbone must have implications since the body relies on a certain minimal amount of marrow for several functions. Not only for people that already have a blood-disease but even from the knowledge that certain blood-diseases can occur with higher ages bone marrow should be a point of consideration when the decision is made for one or another kind of hip prosthesis! Bone marrow should not! Bone marrow should not be removed from the body unless this becomes absolutely unavoidable! This is certainly not the case for the majority of the people that were given traditional /conventional hip prostheses. I dare to say that this point (the implications of marrow removal) has hardly ever been considered in pre-operation consultations. The image on the side shows a section of a thighbone whereby it is indicated how deep (or should I say shallow?) the stem of a BHR and BMHR resurfacing rests in the femoral neck. The bone marrow is with this method never touched or even reached and the femoral canal never opened up either and can not cause an infection in the femoral canal. Contrary to this with a conventional prosthesis (not shown) the femoral neck is removed and the femoral canal opened up.

Here a link about marrow diseases and anemia

Deviations seen in bone marrow

Since bone marrow plays such an important role it stands to reason that as much as possible is kept for in the event that the body is hit by a disease and the marrow is required. For this and many other reasons a hip resurfacing should be chosen above conventional hip prostheses!

Something about bone marrow, see: http://www.djur.cob.lu.se/Svar/Blod.html#rod-gul-benmarg

With the following diseases the quality and quantity of bone marrow is of importance:

– Leukemia, see: http://www.cancerfonden.se/sv/cancer/Cancersjukdomar/Leukemi/

– MDS or MyeloDysplastisc Syndrome, a tumor disease affecting the bone marrows stem cells leading to low blood counts, see: MyeloDysplastisc Syndrome

– A Wikipedia link with information about marrow

– AML or Acute Myeloid Leukemia, affects the bone marrow and can occur as a result of MDS, see: http://www.internetmedicin.se/page.aspx?id=806