Abstract
Fifty five primary Ultima® hybrid all-metal (Johnson & Johnson Professional DePuy) total hip replacements (THR) were evaluated prospectively at a mean follow up of 24 months. Patients were selected according to age and activity levels. The mean age at surgery was 58 years (41–69 years). 33 males and 22 females were included in the study. Surgery was carried out for osteoarthritis in 52 patients and for non-union fractured neck of femur, ankylosing spondilitis and post slipped upper femoral epiphysis in the three remaining patients. A single surgeon (the senior author) through the posterior approach carried out surgery. All patients received the Ultima® porous coated titanium shell with a morse taper cobalt chrome liner and double wedge taper polished stem and modular head. Blood metal ion analysis was performed on a cohort of 24 patients using High Resolution Inductively Coupled Plasma Mass Spectrometry, sampling taken pre operatively and then repeated post operatively at 6 months, 1 year and then annually.
Clinical results reported at a mean follow-up interval of 2.016 years have been excellent, with no prosthesis to-date requiring revision and no component migration or radiolucuencies being identified on any follow-up radiographs. One patient has died and one is lost to follow-up. The following non-device related complications were reported in the group, 2 (4%) superficial wound infections, 1 (2%) dislocation, 1 (2%) thrombosis, 1 (2%) IT band defect and 2 (4%) impingement. The dislocation was treated with a closed reduction, the position of the component having been judged as satisfactory. The impingement has resolved by one year in both patients. The results of pre and postoperative blood metal ion analysis in a cohort of 24 patients demonstrate some elevated levels, these levels are similar to those previously reported in the literature.
The Ultima® hybrid all-metal THR may represent a valuable alternative in the younger, high demand patient.
These abstracts were prepared by Mr Peter Kay. Correspondence should be addressed to him at The Hip Centre, Wrightington Hospital, Appley Bridge, Wigan, Lancashire WN6 9EP.
