Abstract
Introduction Hip arthritis in the young has been a problem area in orthopaedics and thrust plate prosthesis (TPP) was developed as an option. TPP is an implant with fixation in proximal femur metaphysis transmitting hip forces to the resected neck. In young patients undergoing a hip replacement such prosthesis preserves proximal femoral bone stock, which is vital for a revision procedure.
The purpose of the study was to evaluate the results of the Thrust Plate Prosthesis as a treatment option for osteoarthritis of the hip in young patients.
Patients & Methods Of the fifty patients (63 hips) reviewed, 31 (62%) were males and 19 (38%) females. Pre-operative diagnosis included primary osteoarthritis (23), developmental dysplasia (8), avascular necrosis (7), Perthes (4), post-traumatic arthritis (3), rheumatoid arthritis (2), ankylosing spondylitis (1), psoriatic arthropathy (1) and slipped upper femoral epiphysis (1). All components were implanted uncemented with metal-on-metal articulation. The average follow-up was 4.04 years (range 12 months–8.5 years).
Results The mean age of the patients was 42.3 years (range 21–57 years). The mean pre-operative Harris Hip Score was 41.9 (range 12–89) and at final follow-up 89.91 (range 41–100). In 25 hips with ≥ 5yr follow-up, the average HHS at final follow-up was 84.5 (range 50–100). Complications included dislocation (2), transient sciatic nerve palsy (1), discomfort from lateral strap (2), implantation of wrong femoral head (1), revision 3 (4.76%) and implant loosening (4) (6.35%).
Conclusion The thrust plate prosthesis is a useful alternative in young patients with hip arthritis and the results are comparable with other uncemented hip replacements. The added advantage is preservation of the proximal femoral bone stock, which can prove useful in future revisions.
Editoral Secretary Mr Peter Howard. Correspondence should be addressed to BHS at the Royal College of Surgeons, 35 - 43 Lincoln’s Inn Fields, London WC2A 3PN.
