Quote:
Originally Posted by ADR seeker
There are ball and socket ADR available in the US but they over rotate. The good ADRs are motion limiting.
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It is amazing how effective marketing in this field is. The makers of the metal on metal prostheses try to make us believe that the poly core prostheses are inferior (and vice versa.) The makers of the keeled prostheses try to make us believe that no-keel is a problem. The makers of the prostheses with less motion try to make us believe that more motion is bad, and the makers of the more mobile prostheses try to make us believe that the opposite is true.
If you are a good candidate and you get a good job done, you stand a very good chance of success. The prosthesis is much less important than other factors, like quality of diagnosis, technically excellent carpentry, etc... If you are a poor candidate or you get a poor implantation, you chance of success is dramatically reduced, no matter which prosthesis you choose.
All of the differences from one device to the next come with advantages and disadvantages. It is difficult to know how much weight to assign to each feature.
All I know is that my lumbar spine is still 1,000 times better than I ever thought it would be. I have known for years that if I were to get lumbar ADR today, it would not be Charite'. However, if I had to choose between Charite' and fusion, I would still take the Charite'. Choose ADR or no ADR based on the merits of motion preservation. Time will lead us to more optimum designs. However, as it stands now, the difference between devices in the current crop of ADR's is sooooo much less important than other factors. IMHO, we will see failed spine surgeries with more optimum designs as often as with less optimum designs, because they fail because of poor indications and technically poor implantations.
Mark