Abstract
Introduction: We present our results after 10 years use of the Kent hip.
Methods: Between 1994 and 2004, 58 patients (m19, f39) aged 52 to 90 (mean 76) had a Kent hip. Indications were for a loose implant (22), recurrent dislocation (6), femoral or stem fracture (9), and other causes (13). An antero-lateral approach with an antero-lateral longitudinal femoral window was used to remove the previous stem and cement. The window was re-attached by cross screws. An average of 7 (4–10) cross screws were used. An uncemented Biomex cup and polythene liner was used in 48 cases and 10 cups were cemented. A modular 28 mm head and variable length neck was used. Recorded anaesthetic grade was ASA Grade II for 33 patients and ASA Grade III in 13 patients.
Results: Operative time was 130 +/− 37.5 min. Mean recorded blood loss was 1300ml (300–4000ml). Patients were up partial weight bearing at a mean of 5 days (2–80). Hospital stay was 19 days (7–212). There were 3 hospital deaths, one from MRSA sepsis, one chest infection and one MI.
Complications included dislocation (13 out of 53 patients or 24.5%), heterotopic ossification (47%), screw fracture (8%), superficial infection (11%) and deep infection (5.7%). Survival tables show an implant survival rate of 85% at 5 years.
Discussion: Most dislocations settled without further surgery. Heterotopic ossification was minor. The Kent hip system is a flexible and robust solution for a wide range of difficult revision cases. It allows early full weight bearing. We prefer the Kent implant to massive re-cementing, bone grafting or Girdlestone excision. We recommend this device for wider use.
Correspondence should be addressed to The Secretary, BHS, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.
