[Fixed femoral implant on the lateral side - Long term results in hip arthritis in young patients].

The total Hip Arthroplasty of Sir John Charnley was a revolutionary step in the treatment of Hip diseases. Currently, the long-term follow-up of such a prosthesis can be estimated from fifteen to twenty years. The question is: is that delay sufficient to treat young patients with severe hip disease?In a recent publication, Rik Huiskes [3] claims that since, Charnley, no so-called innovation has either scientific proof in real efficacity nor in terms of longer longevity. This should not be a surprise for all total hip prostheses are placed in the medullary canal, either with or without cement. In fact, the so-called innovations are minimal modifications in the design of the stem. It is obvious that if these modifications are not efficient, one should not follow line of research. It seems that almost every thing has been written on total hip arthroplasty failure. We must therefore work in another direction, with another criteria.Let us suppose that it is bone, with all its specifications, which is the possible reason for long-term failure. Is the "kuntscher" imperial road, the only highway to deal with the diaphysis of a long bone? Our point of view is that the bio-mechanical aspect of a stem hip prosthesis is no longer of interest. It seems to us that it is in working on bone physiology that a new concept, a new philosophy of a hip stem prosthesis becomes apparent. If the stem can be placed inside the medullary canal, it can be fixed to on the external part of the diaphyseal cortex, below the periosteal layer.This is the purpose of the following article.