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A New Kind of Hip Replacement The G2 represents a confluence of the world's brightest ideas Hoag Hospital Online Community Health Newsletter   The new G2 hip-replacement prosthesis is a shining titanium example of the medical world's potential in the 21st century.
The G2 was developed by a team of orthopedic experts from around the globe who combined open minds and divergent philosophies to meld a new approach. They spanned great distances by exchanging data over the Internet and meeting via video conference. And they created a prosthesis that capitalizes on the potential of human biology and spurs a different kind of thinking. "We were looking for a new way to address a medical problem by opening our minds to global rather than just regional thought," explains James Caillouette, M.D., a Hoag Hospital orthopedic surgeon who led the G2 effort, recruited the team of international experts and gained the endorsement of G2 manufacturer Johnson & Johnson. "The G2 represents a new worldview," says Dr. Caillouette. "We made everyone a partner and used everyone's best science to create a better medical solution." That solution offers advances in each of the two key factors in hip-replacement efficacy: longevity of the prosthesis, and the health of the bone that surrounds it. The geometry of the G2-which is designed to last a lifetime-actually represents the refinement of an earlier prosthesis that boasted an exceptional track record for longevity. "The G2 fits in the femur in a way that preserves the bone by stressing it in a much more natural way," says Dr. Caillouette.  In addition, with this technique the surgeon prepares the femur in a manner that is far less invasive than traditional methods. "Instead of removing bone, we've designed a special broach for the G2 that compacts the bone in the thigh to create a more stable bed for the implant and a natural buffer layer for the prosthesis," explains Dr. Caillouette.
The G2 is also more bone-friendly because it is made of titanium that is grit-blasted to create a roughened texture. "This surface provides much greater biological bone incorporation," explains Dr. Caillouette. "When the body recognizes this surface, it lays down new bone that grows up and onto the prosthesis to a greater degree than other types of surfaces." This fact is particularly noteworthy for older patients, who may have "thin" bones in which surgeons often felt obligated to cement the prosthesis in place. "Typically in North America, we use age as one of the main determinants for the style of prosthesis we choose," admits Dr. Caillouette. "With the G2, we have the right tool to break down that mindset and offer all the technology that was previously reserved for younger patients." An estimated 200,000 hip replacements are performed in the U.S. annually, a number that's growing nearly 5% per year and is expected to explode soon because of the aging population. After two years of intensive testing, the G2 became widely available to the world in 2000, an opportune time to meet increasing demand-and refute the notion that a hip replacement can last only 10-15 years. "We know that failure of a hip-replacement prosthesis is a process not an event, so we are creating a healthier environment for the bone to prevent that process from occurring," asserts Dr. Caillouette. "We live in a health-conscious society. Patients are living much longer, so it is important to give them a prosthesis that translates into a better overall quality of life." The G2 hip replacement is just one of several cutting-edge procedures performed by the more than 40 orthopedic surgeons on staff at Hoag Orthopedic Services. Future issues of To Your Health will feature more of the advances that make Hoag Orthopedic Services one of the most comprehensive and acclaimed programs in Southern California. Made-for-TV hip prosthesis If you think the G2 sounds like an advance that belongs on The Discovery Channel, you're correct. Late last year, the cable network aired a two-part special chronicling one of Dr. Caillouette's colleagues performing bilateral total-hip replacements using the G2 prosthesis. The shows featured Dr. Thomas Vail of Duke University in North Carolina, one of only three medical programs worldwide that began surgically implanting the G2 following its FDA approval in 1998. The others are the University of Heidelberg (the largest orthopedic center in Germany) and, of course, Hoag Hospital. After two years and more than 1,000 successful implantations, the efficacy of the G2 was validated. And now it's widely available to patients-and television viewers-around the globe. |
