Introduction: Trabecular Metal (Tantalum) has been successfully used in Neurosurgery for many years. Acetabular components have only been available in the UK since 2004. The metal’s properties of porosity and a high friction coefficient are attractive, particularly in complex primary and revision hip arthroplasty when surgical challenges include abnormal, deficient or limited bone.

Methods: Two year results of 110 consecutive acetabular reconstructions are presented. The age range was between 27 and 95 years with a predominance of females. The indication in 75 primary hip replacements included, Destructive Osteoarthritis, Dysplasia, Rheumatoid Arthritis, Paget’s and AVN. 35 revisions were performed either two-component or single acetabular exchanges.

Clinical results have been obtained using the Merle d’Aubigne score and bone deficiencies were classified according to the AAOS system.

Results: There have been no failures and radiologically, serial X-rays demonstrate osseo-integration at an early stage.

We have had no cases of deep infection but there have been 3 femoral peri-prosthetic fractures, (1 late) and 2 dislocations.

All patients have been allowed early weight bearing and those patients with over 12 months follow up have an improved Merle d’Aubigne score.

Discussion: The biomechanical properties of Trabecular metal and a modular design permit a press fit technique supplemented by dome screws combined with the possibility of using varying sizes of liner to minimise dislocation or to retain well fixed femoral stems in revision surgery.

The ease of use of the implant has now led to us largely abandoning other reconstructive techniques such as impaction allo-grafting or cages in revision or complex primary hip surgery.

We consider Trabecular metal to be a major advance in acetabular reconstruction on the basis of our initial experience

Purpose: To evaluate the Cable-Ready Cable Grip System in the treatment of peri-prothetic femoral fractures. Materials and Methods: Twenty cases of treated with Cable-Ready Cable Grip System were reviewed retrospectively. Outcome was measured using clinical and radiological observations. Mechanism of injury, fracture types and complications were noted.

Results: Eighteen of the twenty cases reviewed had good or excellent results. One case required re-operation for implant failure, complications included continued pain and mal union.

Conclusions: The cable-ready cable grip system is a simple and secure fixation system for peri-prosthetic femoral fractures. The system functions optimally in situations where the prosthesis remains stable and the correct length of plate is employed.

We report our experience over seven years with a floating radial-head prosthesis for acute fractures of the radial head and the complications which may result from such injury. The prosthesis has an integrated articulation which allows change of position during movement of the elbow.

We present the results in 12 patients with a minimum follow-up of two years. Five prostheses had been implanted shortly after injury with an average follow-up of 49 months and seven for the treatment of sequelae with an average follow-up of 43 months.

All prostheses have performed well with an improved functional score (modified from Broberg and Morrey 1986). We have not experienced any of the complications previously reported with silicone radial-head replacement. Our initial results suggest that the prosthesis may be suitable for the early or delayed treatment of Mason type-III fractures and more complex injuries involving the radial head.

Failure of an acetabular cup is uncommon and has been attributed to wear or creep, trauma or bony irregularities in the acetabulum. We report ten cases in which fracture of the cup occurred at the site of drill holes used to anchor the marker wire. The role of such indentations as stress raisers has not been previously reported; we suggest that deep indentations or grooves should not be placed in the most highly stressed areas and that the cup thickness should allow for predicted wear rates.