Mid-Term Results of Proxima Ultra-Short Anatomical Stem: Analysis of 130 Cases

Melišík, Marian; Hrubina, M; Heřt, J; Cibula, Zoltán; Čabala, J; Nečas, Libor

doi:10.55095/achot2021/009

Cited by 8 publications

(7 citation statements)

References 23 publications

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“…This indicates the physiological load transfer through the proximal femur, as also shown by bone mineral density analysis in the study of Kim et al [ 5 ]. We have observed stress-shielding phenomenon around osseously stable Proxima stems in zone 7, as was also reported by other authors [ 4 – 6 , 8 , 14 ]. Initial varisation and subsidence, without progression after the 6th postoperative month, had not led to implant loosening at the last visit.…”

Section: Discussionsupporting

confidence: 90%

“…Similarly to our study, the authors reported mild migration and varisation in 23 stems (17.7%), which settled without any further progression by the 6th postoperative month. Radiolucent lines were observed around five stems (3.8%) [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…Bony trabecular development around the Proxima stem has rarely been described. It occurred around the distal half of the stem (modified Gruen zones 2–6) and when this phenomenon occurred, the stem was osseously stable [ 14 ]. Our study revealed similar results.…”

Section: Discussionmentioning

confidence: 99%

“…Radiological evaluation during the follow-up period was focused on: stem migration, the presence of radiolucent lines around cup and stem, stress-shielding phenomenon and bony trabecular development in modified Gruen zones for the Proxima stem (zones 1, 2, 4, 6, 7), the “classic” Gruen zones 3 and 5 were not considered (Figs. 2 a– 3 c) [ 14 ]. Stem migration was assessed according to Martel et al [ 15 ].…”

Section: Methodsmentioning

confidence: 99%

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Mid-term results of total hip arthroplasty with anatomical ultra-short cementless stem in patients with developmental dysplasia of the hip Crowe type II

Hrubina,

Necas,

Melisik

et al. 2024

Eur J Orthop Surg Traumatol

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The aim of this study was to present the mid-term results of ultra-short cementless stem total hip arthroplasty (THA) in patients with Crowe type II developmental dysplasia of the hip. The study consists of 68 patients (75 THAs) with a Proxima stem implanted between 2006 and 2015. The clinical results include Harris Hip Scores. Radiological follow-up reports on stem migration, bony trabecular development and radiolucent lines. Kaplan–Meier survival analysis was performed. The mean age of patients was 48.4 years, with a mean follow-up 114 months. The average Harris Hip Score improved significantly from 45.1 preoperatively to 97.6 at the final evaluation (p < 0.001). Stem migration was observed in five hips (in all of them up to the 6th postoperative month, without any further progression of migration or radiological loosening). Bony trabecular development was detected in modified Gruen zones (1, 2, 4, 6, 7 for Proxima stem): in zone 1 (0%), 2 (49.3.0%), 4 (38.7%), 6 (82.7%), 7 (0%). Radiolucent lines were observed around one cup (DeLee and Charnley zone I) and three stems (none was loose, all three with fibrous stable fixation). Complications were found in three hips (4.0%): intraoperative periprosthetic femoral fracture (threated with cerclage wire) in two hips and squeezing hip in one patient (with perioperative ceramic inlay breakage and exchange). No hip was revised. The implant survival was 100.0% both clinically and radiologically. Observations in the mean follow-up of 114 months show that the results (clinical and radiological) of the Proxima stem in patients with Crowe type II DDH are promising.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Mid-term results of total hip arthroplasty with anatomical ultra-short cementless stem in patients with developmental dysplasia of the hip Crowe type II

Hrubina,

Necas,

Melisik

et al. 2024

Eur J Orthop Surg Traumatol

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“…In the use of cemented THA, there is a possibility to extrude the cement through screw holes [ 13 ]. Due to this risk factor and our increasing experience with the use of cementless THA (especially short conservative stems) we started to use non-cemented THA in these cases [ 14 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

Dynamic hip screw in proximal femoral fractures followed by “single-stage” hip arthroplasty—retrospective analysis

Hrubina,

Necas,

Sammoudi

et al. 2023

Eur J Orthop Surg Traumatol

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The aim of this study is to present the results of single-stage total hip arthroplasty (THA) after Dynamic Hip Screw (DHS) failure, or secondary posttraumatic osteoarthrosis. From 2003 to 2020, 15 THAs were performed in group of 15 patients for the treatment of DHS failure, or for late complications following femoral neck and pertrochanteric fractures. The mean follow-up period after arthroplasty was 46.9 months (range 7–139). The patients were evaluated retrospectively—both clinically and radiographically, focussing on the demography, infection rate and other complications (revision surgery), during the year 2023. 9 males and 6 females were included in the study, with a mean age of 56.5 years (range 29–93) at the time of primary osteosynthesis. Each of them had proximal femoral fracture treated primarily with a DHS and then late one-stage revision surgery, with hardware removal and THA implantation. The median time between DHS osteosynthesis and THA was 41.2 months (range 4–114). Four patients (26.6%) had complications after THA, with the need for revision in two cases (13.3%). Dislocation rate was 6.6% (one case), with the need for repeated-revision of THA. The infection rate was 6.6% (one patient) with the need for revision of THA. Peroperative periprosthetic femoral fracture was observed in 13.3% (two patients) without any other problems. Six patients (40%) died during the follow-up period. Single-stage total hip arthroplasty with concomitant hardware removal bears a high- mortality rate, with a higher incidence of postoperative complications compared to elective THA.

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Capability of auxetic femoral stems to reduce stress shielding after total hip arthroplasty

Liu¹,

Wang²,

Zhang³

et al. 2023

Journal of Orthopaedic Translation

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Mid-Term Results of Proxima Ultra-Short Anatomical Stem: Analysis of 130 Cases

Cited by 8 publications

References 23 publications

Mid-term results of total hip arthroplasty with anatomical ultra-short cementless stem in patients with developmental dysplasia of the hip Crowe type II

Mid-term results of total hip arthroplasty with anatomical ultra-short cementless stem in patients with developmental dysplasia of the hip Crowe type II

Dynamic hip screw in proximal femoral fractures followed by “single-stage” hip arthroplasty—retrospective analysis

Capability of auxetic femoral stems to reduce stress shielding after total hip arthroplasty

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