Total Hip replacement: C stem AMT/Elite (Depuy) cemented hip (femur first)
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A cemented total hip replacement should be considered in the elderly population. It is forgiving to the ageing skeleton, there is a lower risk of fracture on both the acetabular and femoral bone when compared to uncemented designs. I favour the C-Stem AMT/Elite as it has a modular broaching system. This allows for intra-operative changes in neck size (high offset verses standard) without the need to change the broach. Furthermore, it allows the femur to be prepared first. I find that preparing the femur first speeds up the operation, by decreasing the number of steps required and allowing scrub staff to bring the required stem into the operating room when they go for the acetabular component.
The Elite cup has excellent revision rates on the National Joint Registry of England, Wales and Northern Ireland 2017 at ten years in combination with both the Exeter (Stryker) and C-Stem AMT (Depuy) stems. I favour the C-stem AMT due to its modular neck options. A ceramic head is favoured as it has slightly lower revision rates compared to metal heads in this construct (NJR 2017) and where possible a 32mm head is favoured to reduce dislocation rates (a 43mm Elite cup requires a 28mm head).
Author:Mr Richard Baker MD, MSc, MB.ChB, FRCS (Tr & Orth)
Institution: The Avon Orthopaedic Centre, Bristol, UK.
- Each operation and the questions associated become a named course in the CPD section
- The operative technique itself is read as a lesson as is any company implant information if this is being assessed.
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- There are additional quiz modules on the surgical steps, the implants and problem cases being added continually
- The course is completed once all the lessons are read and quizzes submitted and passed.
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The pass mark is 75%.
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- Operation Quiz – 1 CPD point
- Surgical steps Quiz – 1/4 CPD point
- Implants Quiz – 1/4 CPD point
- Problem case Quiz – 1/2 CPD point
One CPD point equates to one hour of academic activity
Welcome to the Professional Development question section. The objective of taking these tests is to demonstrate that you have understood all aspects of the assessment and management of patients requiring surgical intevention. On successful completion you will receive a certificate accredited by both the Royal College of Surgeons of both England and Edinburgh as well as the British Orthopaedic Association.
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