Sixty-four patients, in whom the transfixion prosthesis had been implanted five to fifteen years previously, were evaluated clinically and roentgenographically. Clinically, the results in fifty-two of the sixty-four patients (81 per cent) at last examination were graded as excellent, good, or acceptable.
Most consistent good results followed implantation for intracapsular fractures and their complications and for idiopathic avascular necrosis. Results in degenerative arthritis were attained more slowly and were quite satsfactory in hips without major deterioration of the acetabular wall and without acetabular deformity that required reaming. These latter conditions were conducive to progressive acetabular intrusion of the prosthetic head and associated pain.
The transfixion prosthesis appears to have a high degree of stability when implanted in sound tissue. Wobble and rotatory or lateral migration were not observed in any patient. Slow progressive settling and acetabular intrusion were encountered. Their incidence, associated symptoms, and presumptive causes are considered. Some of these complications, in retrospect, may be preventable. Some continue to be unpredictable and others, referable to pre-existing tissue defects are now recognized as contraindications to the prosthetic method.
The study suggests that the transfixion prosthesis inserted with precision into healthy osseous tissue provides a degree of stability more secure than that attained by unit instruments.
Copyright 1967 by The Journal of Bone and Joint Surgery, Incorporated