The thrust plate prosthesis (TPP) is a femoral implant which stimulates physiological loading. This eliminates stress shielding, hence subsequent aseptic loosening of the femoral endo-prosthesis (Huggler/Jacob et al).

Between December 1994 and December 1999, TPP (third generation prototype) were inserted in 63 hips in 58 patients between the ages of 19 and 75.

This is a study and follow-up of one single surgeon. 46 hips in 41 patients were available for follow-up, clinical assessment (Harris Hip Score) and radiological evaluation (Buergi et al).

The average hip score improved from a pre-operative score of 39 to 94 postoperatively. All patients achieved their occupational status post-operatively.

Radiological evaluation assesses the cortical bone reaction in the mediocaudad zone of the femoral neck to the thrust plate. 36 hips (80%) maintained excellent osseous ingrowth between the mediocaudad femoral neck and the flat surface of the thrust plate (Type I reaction).

There were 3 loosenings (technical error/poor selections), 1 deep infection, 2 stress fractures, 9 (20%) myositis ossificans, 1 broken screw and no dislocations.

Implantation requires:

pre-operative templating,

careful precision with the preferred 130° of neck femoral shaft angle

firm osseous fixation

Revision surgery, if required, is uncomplicated. It will be as for implanting a primary endo-prosthesis due to the preservation of excellent bone stock. The study shows promise of longevity and one hip arthroplasty for life, especially in young patients.