CANNULOCK HIP SYSTEM FOR THE MANAGEMENT OF PROXYMAL FEMORAL PATHOLOGY

Abstract

Proximal femoral fractures, whether it is due to meta-static destruction or periprosthetic fractures with loose femoral component with secondary osteolysis of the proximal femur in the elderly patient is a major task. We find the Cannulock hip system quite useful in tackling this issue. It offers various options for the management of this complex pathology.

We present the results of 11 Cannulock Hip Arthroplasty performed in 10 patients (Age Range 55–92). 6 out of 11 patients was noted to have metastatic destruction of proximal femur including the head and neck down to lesser trochanter. Ca of Bronchus and Breast with multiple bony metastsis were responsible for these cases. 4/11 had loose femoral component with type 2 periprosthetic fractures. 1 out of 11 had failed DCS fixation for Reverse oblique fracture. The procedures were done in a district general Hospital in the UK between August 2001–Jan 2006. The patients were mostly ASA 4.

The Cannulock Hip system offered the simplicity of a Hemiarthroplasty with an advantage of Intramedullary nailing option. This has the option of fitting standard Bipolar Head or 22 mm metallic head in case of Peri Prosthetic fracture where the acetabular component is intact. Long stem with HA coating and standard options for cemented stem insertion. The long stem with a bow enables easy insertion with distal locking facility.

In our study all the patients were excellent with both clinical and readilogical out come, however sadly 1 patient died with in 3 months of surgery. 5/6 patients with metastatic bone tumour were discharged at the mean of 8 weeks with no clinical concerns. 4 patients with femoral stem revisions and 1 patient with failed DCS were discharged at a mean of 4 months. We find the Cannulock hip arthroplasty system quite versatile in the management of these complex injuries.