This is a prospective study looking at 116 consecutive total hip replacements in 110 patients using the C-Stem total hip replacement system (Depuy International, Leeds, UK) between March 2000 and October 2002. This is the first documented study of results of the C-Stem outside Wrightington Hospital where it was developed.

There were 69 females and 41 male patients. Average age was 66 years (Range 32 – 89 years). 64 patients had a right hip replacement, 52 patients had a left hip replacement and 6 were bilateral. The duration of follow up was from 24 to 55 months, with an average of 38.75 months.

All patients had a cemented C-stem via a posterior approach. 107 with a metal head and 9 with a ceramic head. Cemented, all polyethylene cups were used. 82 hips had an Opera cup inserted and 34 had an Ogee cup inserted. Palacos R with Gentamicin was used for the cement.

103 femoral stems were neutral.12 stems were in varus (5–10 degrees) and 1 stem was in valgus (5–10degrees). No stems were greater than 10 degrees in either direction. There were no lucencies in any of the zones described by Gruen. The average amount of subsidence of the stem was 0.86mm (range 0–4mm).

The average cup angle was 44.29 degrees (SD = +/− 4.85). 8 acetabular components had a 0.5mm lucent area in zone 1 and 2 acetabular components had 1mm lucent area in zone 1. All of these lucencies were present on the immediate postoperative x-ray and none were progressive.

There were no lucencies in the other zones. There have been no incidences of deep infection, fatal P.E, dislocation or revision.

We conclude that the C-Stem has produced excellent results in the short term in keeping with the criteria of the NICE guidelines.

Purpose of study : – To highlight possible complications following Philos plating of proximal humeral fractures.

Methods : – 10 patients with proximal humeral fractures operated upon in period 2003–2004 were reviewed. Analysis was undertaken with observer xray review and using radiograph analysis software.

Results : – In 3 cases the fracture had collapsed significantly resulting in cut out of the proximal screws. One case required implant removal within a month following initial surgery. In another case the radiographs were not standardised views to compare the amount of collapse. The other cases went onto healing without any complication.

Conclusions : – As the Philos plate is a fixed angle implant the degree of collapse expected must be accounted for when fixing the implant this is especially important in osteoporotic patients or in those with a high degree of comminution. In these circumstances high placement of the plate and long proximal screws should be avoided.