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Derek McMinn is a British orthopaedic surgeon and inventor who practises in Birmingham, United Kingdom at the BMI Edgbaston Hospital. Mr. McMinn developed the first successful modern metal-on-metal hip resurfacing and the instrumentation and surgical technique to implant it. Hip resurfacing is a bone-conserving, less invasive alternative to total hip replacement (THR) for young patients,〔(The Birmingham Hip Resurfacing )〕 markedly improves the health-related quality of life measures and currently makes up around a tenth of all hip arthroplasty (artificial joint) procedures performed in the United Kingdom.〔(National Joint Registry 2009 )〕 McMinn is also the inventor of several other prostheses for the hip〔Willemse P, Castelein RM, Bom PL, Verburg A, Verheyen CC. Clinical and radiological results of the stemmed Mc Minn cup in hip revision surgery. Acta Orthopedica Belgica 2010 Feb;76(1):58-62〕〔Badhe NP, Howard PW. Partially hydroxyapatite-coated stemmed acetabular cup and nonstructural bone-graft in the management of severe acetabular deficiency. Journal of Arthroplasty. 2000 Jan;15(1):63-8〕 and knee. Derek McMinn is the author of ''Modern Hip Resurfacing'' (ISBN 978-1848000872), published in 2009. ==Hip Resurfacing== ;BIRMINGHAM HIP RESURFACING (BHR) Mr. McMinn first began performing hip resurfacing procedures in 1991 using the McMinn Resurfacing.〔 The rationale behind the procedure was that it would be a bone-conserving alternative to THR for patients with higher activity demands i.e. young patients with severe hip arthritis who are otherwise in good health. This would buy time until they reached an age at which they would be more suitable for a THR. THRs utilise small diameter metal-on-polyethylene bearings which have a high rate of dislocation and revision in this group of patients. Sir John Charnley originally developed the conventional THR in the 1950s, which proved to be one of the most successful operations in the world. In this procedure the 'ball' part of the hip joint (femoral head) and a portion of its neck are removed and the 'socket' part (acetabulum) is grated in preparation. These are replaced with an artificial ball and socket with a long stem in the thigh bone. This and other designs of THRs have since transformed the quality of life of millions of old patients with severe hip arthritis. Because these devices contained polyethylene as one of the rubbing surfaces, Charnley was justifiably very wary of using it in young patients. He warned against the use of a THR in any young patient unless there were other physical restraining factors which would stop her/him from getting back to high activity levels. True to his prediction when these THRs were used in young patients they failed early even in the best centres on the world, including Charnley's own centre at Wrightington in the UK. The Swedish Hip Register shows that in young patients, 19% of THRs failed 10 years after the operation and 67% had failed by 16 years.〔(Henrik Malchau, Peter Herberts, Peter Söderman, Anders Odén, Department Of Orthopaedics,, Göteborg University, Sweden., www.jru.orthop.gu.se )〕 Because these patients are young, early failure implies the need for repeated revision operations using progressively more invasive and more complex devices. It was therefore always attractive to surgeons to employ a bone conserving procedure in young patients initially. When they need a revision there is more useful bone preserved to fix the new device to. McMinn's technique of resurfacing employs thin (3–4 mm) metal surfaces to line the patients' own hip. In contrast to a THR, the femoral head and neck are retained in this procedure. These large diameter resurfacings match the patient’s own anatomy. Because they do not contain polyethylene, these bearings wear at a much lower rate, provided they are manufactured according to specifications, and are implanted well. These allow the patients to return to higher levels of activity after the operation without the fear of early wear. Furthermore, because the devices have the same diameter as the patients' own, they are less prone to dislocation. Over the following years, McMinn further improved the design and operative technique, eventually developing the Birmingham Hip Resurfacing (BHR). The first BHR was implanted in July 1997, in Birmingham, England. Over the next few years its success spurred surgeons all over the United Kingdom, Europe, Australia and many parts of Asia to start performing the procedure. On 9 May 2006, the FDA approved the BHR for medical use in the United States.〔(FDA Approval for the BHR )〕 Following thirteen years of usage McMinn reports 96% success with his BHRs in all patients and all diagnoses. These resurfacings are particularly successful in young patients who are the worst group for THRs. His success rate of the BHR in this age group is 98% at 13 years. Several other series and national registers also show similar results of around 95% currently with the BHR. The 2009 Australian National Joint Replacement Registry reported a 95% success rate for the BHR.〔(2009 Australian National Joint Replacement Registry )〕 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Derek McMinn」の詳細全文を読む スポンサード リンク
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