ABSTRACT
[Objective] Total hip replacement has given good results in the elderly population but with an increasing number of younger patients requiring hip replacement,soft tissue and bone preservation has become important.Studies have shown that a more natural loading of the proximal femur leads to preservation of bone stock and aids remodeling.Proxima hip was developed keeping these requirements in mind.[Methods] Twenty nine Proxima hip replacements were performed on twenty one patients between July 2006 and March 2008 by the senior author.The average age of the patients at the time of surgery was 44 years.Eight of the patients had bilateral hip replacement in the same sitting.The implant used was a Proxima stem with a large diameter metal on metal XL head.Particular care was taken in preserving the full length of femoral neck and the trechanteric muscles.The patients were assessed by Harris hip acore,return to normal and advanced hip functions and satisfaction levels.All patients were followed up with serial X rays and clinical examination.[Results] Average duration of follow up was 1 year.The mean Harris hip score pre surgery was 48 and at last follow up was 88.All patients at 3 to 4 months achieved full weight bearing.One patient had an intra-operation fracture of the lateral cortex which recovered without any sequelae.Another patient had persistent thigh pain without any apparent cause and a poor result.One stem was revised because of aseptic loosening after 9 months.None of the hips showed any sign of acetabular cup loosening or migration.[Conclusions] Early results in this young group of patients are very encouraging.This small implant relies on the preserved neck and the lateral flare for its stability,ensuring a more natural loading of the proximal femur and preserving bone stock and facilitating remodeling.As our results show the Proxima stem as an implant that stands the test of biomechanics and holds a promising future.