Abstract
The Huckstep ( Bbraun Medical) interlocking hip prosthesis has been used in the Sheffield Lower Limb Arthroplasty Unit in cases of complex primary and revision hip arthroplasty since 1996. We reviewed the outcomes in cases performed prior to October 2001.
Eighty cases were identified. Of these, eight died within one year of surgery, four of which were in the peri operative period. A further thirteen were lost to follow up in the first year due to medical deterioration, move from area or refusal to attend. The remaining 57 patients had a mean time to follow up of 34 months (12–81m).
As a primary prosthesis the Huckstep was used to allow corrective osteotomy. In revision cases it was employed to bypass periprosthetic fractures and fragile proximal femoral bone, in cases requiring extended trochanteric osteotomy to facilitate cement removal, and to enable use of bulk proximal femoral allograft. The use of the Huckstep was planned pre operatively in 67 cases and as a salvage option in 13.The design of the implant allowed a stable construct without the need for bone cement which could interpose and prevent bone healing or graft incorporation. It avoids problems incurred in pressurising cement or impaction grafting against fragile bone.
Complications included infection requiring further surgery (5), dislocation (5), periprosthetic fracture (2), screw breakage (4), and mechanical failure (2). Eleven patients required further revision surgery. The apparently high complication rate reflects the complex nature of the surgery and the high degree of co morbidity in the elderly patient group.
In conclusion, we have found the Huckstep hip prosthesis to be a useful option in cases of complex hip surgery. Whilst the long term outcome is as yet unknown, our short term results show it to have allowed healing of fractures, osteotomy sites and cortical defects, allograft incorporation and replenishing of bone stock, hence facilitating further arthroplasty surgery.
Theses abstracts were prepared by Mr Peter Kay. Correspondence should be address to him at The Hip Centre, Wrightington Hospital, Appley Bridge, Wigan, Lancashire WN6 9EP.
