The DePuy Proxima™ Hip: A Short Stem for Total Hip Arthroplasty. Early Experience and Technical Considerations

The rationale for short stems in cementless total hip arthroplasty (THA) is proximal load transfer and absence of distal fixation resulting in preserved femoral bone stock and avoidance of thigh pain. We report a consecutive series of 65 THAs inserted mainly for osteoarthritis with the DePuy Proxima^™ hip, a short, anatomic implant with a pronounced lateral flare. Patients were assessed preoperatively and postoperatively at 3, 6 and 12 months and annually thereafter, using the Harris Hip Score (HHS), the Oxford Hip Score (OHS) and standard radiographs. No thigh pain was reported. At a mean follow-up of 1.7 years the HHS improved from a preoperative mean value of 51 to 91 and the OHS decreased from a mean value of 42.5 to 12.4. Complications included 1 intraoperative fracture, 1 superficial infection, and 3 deep vein thromboses. The proximal medial edge of the resected femoral neck appeared rounded off in 49 cases whilst in 16 cases a further loss of medial cortical density was observed. Patient selection and surgical technique are crucial factors contributing to a successful outcome. The surgical technique is different from standard THA.