PROXIMATOTALHIPREPLACEMENT.docVIP

PROXIMA TOTAL HIP REPLACEMENT By Nady Saleh El-Sayed El-Shwikh*, Ahmed Mohamed Abd- El Aal**, Mohamed Mahmoud El- Sayed Fadel*, Ahmed Mohamed Ahmed Othman*, and Mohamed Atif Ahmed* Department of Orthopaedics, *Minia University and **Assiut University ABSTRACT: We present the clinical and radiographic outcome of 15 consecutive primary total hip replacements performed in 13 patients under the age of 55 years using a Duofix (hydroxyapatite and porous coated) femoral component and cementless cup with a modular ceramic and metal heads. We reviewed 15 (100%) hips at a mean follow-up of 25.1 months (12 to 44) after implantation. No cases were lost during follow-up. Radiographic review of the hips did not identify any evidence of femoral or acetabular loosening. The mean Harris Hip Score jumped from 19.9(4-51) to 85.9 (67-95). The HHS gives promising functional and radiographic results in all patients in the medium term follow up. Total hip replacement (THR) in the younger patient presents a particular challenge. High physical demands and the need for long-term implant survival make good surgical technique and an appropriate choice of implant important. The revision rate of cemented implants may be high. The use of Duofix coated cementless implants in THR has been well-established. However, there is a lack of papers which address their outcome in the younger patient. KEYWORDS: Proxima Total hip replacement Stress shielding INTRODUCTION: Cementless femoral stems of many designs, reflecting a broad range of bone attachment rationale, provide dependable long-term fixation. However, a number of Issues related to cementless stem fixation exist which might increase their safety, versatility and durability. These issues include the optimization of load transfer to the proximal femur to maximize bone preservation and restoration and elimi-nation of the potential for a mismatch in proximal-distal fit (Such a condition might –exist in the presence of an excessively bowed femur,