Depuy | Proxima Short Stem Hip Prosthesis | Which Medical Device

Description

From Which Medical Device

The Proxima Short Stem from Depuy is a proximally loading short stem hip prosthesis made of forged titanium alloy, with a Duofix™ porous coating and hydroxyapatite surface coating. It is available in nine sizes with standard and high-offset variants. The paper by Toth (1) gives several excellent pieces of advice for users of this stem. It suggests that the device is contraindicated in severe osteoporosis, gives advice about the importance of accurate femoral neck resection, and suggests fluoroscopy to avoid varus implant positioning. Ghera (2) has also reported early experience.

Although the stem has been said to suit younger patients in particular, Kim et al (3) reported early results of 84 implantations of the Proxima Hip in elderly patients (mean age 78.9, range 70 to 88). At a mean of 4.6 years (4 to 5), there was no visible osteolysis, no subsidence, good osteointegration and minimal stress shielding. Alignment of the stem was excellent with only 4 stems (5%) in a varus position. The authors suggest that this stem might be a good solution for elderly patients, and one which avoids thigh pain and the risks of cementation. 

In the Seventh UK National Joint Registry report, there were 132 implantations, and the device was rated pre-entry with ODEP.

For a review of short stem hip replacements, see our news article.

References:

(1) Kálmán Tóth, László Mécs, Péter Kellermann. Early Experience With The DePuy Proxima Short Stem In Total Hip Arthroplasty. Acta Orthopaedica Belgica 2010, N° 5 (Vol. 76/5) p.613-648

(2) Ghera, S; Pavan, L. The DePuy Proxima (TM) hip: a Short Stem for Total Hip Arthroplasty. Early experience and technical considerations. Hip International 2009. 19(3); 215-220

(3) Kim Y-H, Kim J-S, Park J-W, Joo J-H. Total hip replacement with a short metaphyseal-fitting anatomical cementless femoral component in patients aged 70 years or older. J Bone Joint Surg (Br) 2011; 93-B:587-92.