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Research

PRIMARY AND REVISION TOTAL HIP ARTHROPLASTY IN DISTORTED PROXIMAL FEMORAL ANATOMY – THE ADVANTAGES OF A STEMLESS METAPHYSEAL LOADING IMPLANT

West of Scotland Orthopaedic Research Society (WOSORS) - 4th Annual Meeting



Abstract

Total hip arthroplasty is well established as a successful treatment modality for end stage arthritis, with a variety of components currently available. However, utilising traditional stemmed implants in patients with distorted proximal femoral geometry can be technically challenging with increased risk of complications.

We present seven patients with distorted proximal femoral anatomy or failed hip arthroplasty in whom a technically challenging primary or revision operation was simplified by use of a Proxima stem. This is a short, stemless, metaphyseal loading implant with a pronounced lateral flare.

At twelve months follow up there have been no complications with average improvement in Oxford and Harris scores of forty and forty-nine respectively. Radiological analysis shows all stems to be stable and well fixed.

Designed primarily as a bone conserving implant for primary hip arthroplasty we propose that the Proxima prosthesis also be considered in cases where a conventional stemmed implant may not be suitable due to challenging proximal femoral anatomy. The use of the stemless Proxima implant provided a simple solution in seven difficult and potentially lengthy complex primary and revision hip arthroplasties with gratifying clinical and radiological outcomes.