Surgeon who used the uncemented cup must choose between two kids of cups: the porous coated (press fit) and the threaded. Many authors present several discouraging results. Nevertheless satisfactory results have also been obtained using threaded cups and the explanation lays in the design the alloy and the surface characteristics of the acetabular component. We describe the clinical and radiological outcome of 93 THA in 81 patients using a screw-in cup (Link- type) performed between 1994–2000. Our follow-up time was and the average age of the patients was 68y,all were primary THA(78 OIA,15 sub-capital fractures).Clinical evaluation was perfomed using the Merle d’ Aubigne hip score.
The mean age was 48y. The technique consists of:
Anatomic reduction (with a C-arm), which was the most crucial point of the technique. Secure fixation with three cannulated screws (Asnis) A like tube graft from the iliac crest was placed on the neck of the femur, posteriori to increase the vascularity of the head. Weight bearing was permitted after 6 m and if the fracture was healed.
Therefore, the pathologic tissue must be excised and often a large defect is created. Different procedures have been described to repair this defect.
This procedure consists in turning down a fascia flap from the gastroknernius to bridge the gap and end-to-end suture. In 13 patients the plantaris tendon has been used as a reinforcing membrane. In 2 cases we didn’t found it. We didn’t have any postoperative complications. After care a long -leg cast is applied with sufficient equinus of the foot and flexion of the knee for 6 weeks. For 6 weeks more a short leg cast was applied with the foot in neutral position and weight hearing was slowly resumed.
We had 2 far results and 1 poor but -no rerupture. The gap that we were obliged to repair was between 3cm–8cm