Acta Ortopédica Mexicana

Morales de Cano JJ, Vergara P, Valero J, Clos R
Use of metaphyseal stems «Proxima» DePuy: our experience to more than five years
Acta Ortop Mex 2018; 32 (2)

Language: Español
References: 25
Page: 88-92
PDF: 203.16 Kb.

[Fulltext - PDF]


The total hip arthroplasty with short stems to preserve bone is a good choice in young patients that expected future revision surgery, it is also a good choice when we use approaches for minimal invasive surgeries. In this study, we have evaluated, clinically and radiologically, our experience in total hip arthroplasty with the use of short stems and metaphyseal anchorage. In total we have involved 23 patients with a mean age of 50.2 years (range 45 to 69 y/o) at the time of surgery. The median follow-up was greater than five years. There was a slight Varus femoral stem in three cases, one of them in severe varus. The latter presented continuous pain in the lateral aspect of the thigh that increased with time, with a diaphyseal reaction and an increase in radiolucencies around the stem that required revision surgery 12 months postoperative. A longer follow-up is required to analyze the results and confirm the durability of the observed clinical findings. Patients were evaluated radiological and clinically using the scale of Merle d’Aubigné (MD).

Key words: Short stem, saving of bone, hip arthroplasty.


  1. Buergi ML, Stoffel KK, Jacob HA, Bereiter HH. Radiological findings and clinical results of 102 thrust-plate femoral hip prostheses: a follow-up of 2 to 8 years. J Arthroplasty. 2005; 20(1): 108-17.

  2. Morrey BF. Short-stemmed uncemented femoral component for primary hip arthroplasty. Clin Orthop Relat Res. 1989; (249): 169-75.

  3. Thomas W, Lucente L, Mantegna N, Grundei H. ESKA (CUT) endoprosthesis. Orthopade. 2004; 33(11): 1243-8.

  4. Ishaque BA, Wienbeck S, Stürz H. Midterm results and revisions of the thrust plate prosthesis (TPP). Z Orthop Ihre Grenzgeb. 2004; 142(1): 25-32.

  5. Fink B, Siegmüller C, Schneider T, Conrad S, Schmielau G, Rüther W. Short- and medium-term results of the thrust plate prosthesis in patients with polyarthritis. Arch Orthop Trauma Surg. 2000; 120(5-6): 294-8.

  6. Renkawitz T, Santori FS, Grifka J, Valverde C, Morlock MM, Learmonth ID. A new short uncemented, proximally fixed anatomic femoral implant with a prominent lateral flare: design rationals and study design of an international clinical trial. BMC Musculoskelet Disord. 2008; 9: 147.

  7. Learmonth ID. Conservative stems in total hip replacement. Hip Int. 2009; 19(3): 195-200.

  8. Hube R, Zaage M, Hein W, Reichel H. Early functional results with the Mayo-hip, a short stem system with metaphyseal-intertrochanteric fixation. Orthopade. 2004; 33(11): 1249-58.

  9. Kishida Y, Sugano N, Nishii T, Miki H, Yamaguchi K, Yoshikawa H. Preservation of the bone mineral density of the femur after surface replacement of the hip. J Bone Joint Surg Br. 2004; 86(2): 185-9.

  10. Martell JM, Pierson RH 3rd, Jacobs JJ, Rosenberg AG, Maley M, Galante JO. Primary total hip reconstruction with a titanium fiber-coated prosthesis inserted without cement. J Bone Joint Surg Am. 1993; 75(4): 554-71.

  11. Engh CA, Bobyn JD, Glassman AH. Porous-coated hip replacement. The factors governing bone ingrowth, stress shielding, and clinical results. J Bone Joint Surg Br. 1987; 69(1): 45-55.

  12. Engh CA, McGovern TF, Bobyn JD, Harris WH. A quantitative evaluation of periprosthetic bone-remodeling after cementless total hip arthroplasty. J Bone Joint Surg Am. 1992; 74(7): 1009-20.

  13. Kim YH, Oh SH, Kim JS. Primary total hip arthroplasty with a second-generation cementless total hip prosthesis in patients younger than fifty years of age. J Bone Joint Surg Am. 2003; 85-A(1): 109-14.

  14. Santori F, Rendine M, Fredella N, et al. Ultra short stem with proximal load transfer: Clinical and radiographic results at 4 yrs follow up. J Bone Joint Surg Br. 2006; 88(suppl I): 54.

  15. Henry JD, Reilly D, Poss R. Two- to four-year experience with cemented, press-fit, and porous coated applications of the profile total hip system. Acta Orthop Belg. 1993; 59 Suppl 1: 190-4.

  16. Morscher EW, Widmer KH, Bereiter H, Elke R, Schenk R. Cementless socket fixation based on the «press-fit» concept in total hip joint arthroplasty. Acta Chir Orthop Traumatol Cech. 2002; 69(1): 8-15.

  17. Donnelly WJ, Kobayashi A, Freeman MA, Chin TW, Yeo H, West M, et al. Radiological and survival comparison of four methods of fixation of a proximal femoral stem. J Bone Joint Surg Br. 1997; 79(3): 351-60.

  18. Freeman MA, Plante-Bordeneuve P. Early migration and late aseptic failure of proximal femoral prostheses. J Bone Joint Surg Br. 1994; 76(3): 432-8.

  19. Krismer M, Biedermann R, Stöckl B, Fischer M, Bauer R, Haid C. The prediction of failure of the stem in THR by measurement of early migration using EBRA-FCA. Einzel-Bild-Roentgen-Analyse-femoral component analysis. J Bone Joint Surg Br. 1999; 81(2): 273-80.

  20. Schmidt R, Muller L, Kress A, Hirschfelder H, Aplas A, Pitto RP. A computed tomography assessment of femoral and acetabular bone changes after total hip arthroplasty. Int Orthop. 2002; 26(5): 299-302.

  21. Sychterz CJ, Claus AM, Engh CA. What we have learned about long-term cementless fixation from autopsy retrievals. Clin Orthop Relat Res. 2002; (405): 79-91.

  22. Ender SA, Machner A, Pap G, Hubbe J, Grashoff H, Neumann HW. Cementless CUT femoral neck prosthesis: increased rate of aseptic loosening after 5 years. Acta Orthop. 2007; 78(5): 616-21.

  23. Ghera S, Pavan L. The DePuy Proxima hip: a short stem for total hip arthroplasty. Early experience and technical considerations. Hip Int. 2009; 19(3): 215-20.

  24. Gilbert RE, Salehi-Bird S, Gallacher PD, Shaylor P. The Mayo Conservative Hip: experience from a district general hospital. Hip Int. 2009; 19(3): 211-4.

  25. Tóth K, Mécs L, Kellermann P. Early experience with the Depuy Proxima short stem in total hip arthroplasty. Acta Orthop Belg. 2010; 76(5): 613-8.