Can Hip Implants Be Secured To The Bony Hip?

Q: Dr. Eppley, I have to say I am very interested in the locking mechanism of your own design from a recent blog post. I can’t help but wonder if this could be utilized to facilitate slightly larger implants? As you have noted previously, due to the vertical placement of hip implants they are at risk for impact forces over time, folding, mal-rotation among others. Of course to mitigate some of that you can use higher durometer implants with the trade off being less of a feathered edge and likely more risk of implant show especially in thin patients. Perhaps if you created a locking mechanism for larger implants (see see pictures for my potential interpretation based off of your previous designs), you could use the iliac implant as a boney anchor that would support the implant, with less force directed to the inferior edge as a result. This might allow you to use a softer durometer implant with a more general and natural appearing feathered edge.

A: In comments to your inquiry:

1) Higher durometer implants can have very feathered edges. Implent edging is not affected by material durometer.

2) A major component of Implant show is a thin subcutaneous fat layer.

3)  The locking mechanism for hip implants used with iliac crest plates can be used with any implant design or size.  Its major benefit is that it would prevent implant bending at the bottom edge of the implant.

4) One developing idea for hip implants is to use a very small iliac crest plate fora superior bone anchor for hip implants.

Dr. Barry Eppley

World-Renowned Plastic Surgeon