In another step forward on the hip-replacement front, orthopedic surgeons Michael Ain and Frank Frassica have come up with techniques that make the operation available to a group of patients whom doctors usually turned away—those whose full height is under 4 feet because of stunted and deformed bone growth known as skeletal dysplasia. Until recently, the specially designed artificial hips and surgical tools necessary for people this small weren’t available. "You can’t just take an off-the-shelf artificial hip," Ain explains. The diminutive, irregular bone structure and poor bone quality of these patients also makes them technically challenging for surgeons to operate on, as do conditions like neck instability. "Physicians would simply tell them they weren’t candidates for the hip surgery," Ain says. Now Ain and Frassica have collaborated with biomedical engineers to design smaller prostheses and instruments, especially adapted to these patients. They use a dental burr-like instrument, rather than a conventional orthopedic drill to carve out a canal in the thigh bone for the stem of the hip implant. They also create smaller, computer-generated prostheses with special CT scans. Key to success in these complicated cases is surgical experience and clinical expertise. Historically, Hopkins has had a large interest in skeletal disorders, Ain notes, citing the world-renowned Greenberg Center for Skeletal Dysplasias: "It lets us push the envelope in offering new kinds of help to these small people." -- Gary Logan,
Hopkins Medical News, Spring 2001 | 
