Design aspects and clinical performance of the thrust plate hip prosthesis

Abstract The thrust plate hip prosthesis (TPP) was conceived to maintain the physiological stress distribution in the proximal femur so as to prevent bone atrophy in this region, often encountered after implantation of conventional stem-type prostheses. A thrust plate of TiAlNb is firmly fixed to th...

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Bibliographic Details
Published in:Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine Journal of engineering in medicine, 2007-01, Vol.221 (1), p.29-37
Main Authors: Jacob, H A C, Bereiter, H H, Buergi, M L
Format: Article
Language:English
Subjects:
Adult
Age
Aged
Atrophy
Biocompatible Materials - chemistry
Bone Plates
Bone remodeling
Clinical Trials as Topic
Cortical bone
Equipment Design - methods
Equipment Failure Analysis
Female
Femur
Forges
Hip
Hip joint
Hip Prosthesis
Humans
Implantation
Integration
Male
Metaphysis
Middle Aged
Neck
Patients
Physiology
Plates (structural members)
Prestressing
Prostheses
Prosthetics
Stress
Stress (physiology)
Stress analysis
Stress concentration
Stress distribution
Structural stability
Survival
Thrust
Trochanter
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Summary:Abstract The thrust plate hip prosthesis (TPP) was conceived to maintain the physiological stress distribution in the proximal femur so as to prevent bone atrophy in this region, often encountered after implantation of conventional stem-type prostheses. A thrust plate of TiAlNb is firmly fixed to the neck of the femur by means of a forged CoCrMo bolt introduced through the lateral cortex, just below the greater trochanter, and through the metaphysis. A boss that contains the bolt head rests on the lateral cortex. A proximal extension from the thrust plate terminates in the ball head of the hip joint. Bone remodelling causes the initial prestressing of the structure (primary stability) to decline, but full integration of the thrust plate with the underlying host bone affords secondary stability. A total of 102 TPPs were implanted in the Cantonal Hospital, Chur, Switzerland, from 1992 to 1999 in 84 patients. The TPP was selected particularly for patients of the younger age group (26-76). Through its ability to load the medial cortex of the proximal femur in a physiological manner, the cortical bone in this region is preserved. The mean Harris hip score is 97 points and the survival rate 98 per cent, 144 months post-operatively.
ISSN:0954-4119
2041-3033
DOI:10.1243/09544119JEIM111