ICON as a Result of Evolution

For over 100 years surgeons have attempted to develop the idea of surface replacement. The attempts involving various concepts ultimately failed as a result of material or fixation problems. The last attempt in the 70s (Wagner, Freeman) failed after initially encouraging results, primarily due to massive loosening of the prostheses. After 5 years a failure rate of more than 50% had to be noted.

The main reason, as became apparent later, was the abrasion of the polyethylene cup used. This abrasion generated severe osteolysis, which spread out into the borders of the implant and led to failure of the system due to femoral neck fracture or loosening of the cup. At that time polyethylene was the material of choice in the cup region and was supposed to achieve adequate lubrication of the joint partner.

However, already in the 60s McKee-Farrar, Huggler and Ring developed the first hip prostheses with metal on metal bearing, which gave good long-term results (see Fig. 02). In the case of revisions, after working times of over 25 years no metallosis in these implants due to increased abrasion was observed.

Based on experience with the metal on metal prostheses of that time, the English surgeon Derek McMinn, working with Corin Medical Ltd., developed a metal on metal resurfacing that was implanted for the first time in 1991. A variety of implant designs were developed and implanted. The cooperation with Corin Medical ended in 1996.

With the founding of the company MMT (Midland Medical Technology) in 1996, Derek McMinn brought his experience into the company and presented in 1997 the BHR (Birmingham Hip Resurfacing), the optimum of his scientific know-how.
In 2004, MMT was taken over by Smith & Nephew. Up to 2006 over 50,000 systems were successfully implanted. The BHR System achieved 2006 the FDA Approval in the USA.

Marc Bittenbinder, who up until 1996 had exclusive distribution rights of Corin and 1997 – 2003 exclusive rights of MMT in Germany, founded the company IO International Orthopaedics Holding GmbH in 2003. IO is the manufacturer of the ICON Hip Resurfacing Prosthesis, which shares McMinn’s experiences and, above all, is working on new surgical techniques and instruments for minimal invasive implantation.