[Pain in the thigh following Zweymüller's total endoprosthesis: computerized tomography studies of the morphological behavior of the metadiaphyseal femur].
Since March 1983, 473 Zweymüller prostheses have been implanted at the authors' clinic. A total of 413 patients were examined subsequently; the mean follow-up period was 20 months. On the basis of the follow-up examinations the patients can be classified in three groups with regard to thigh pain: Patients who were completely free of pain at the time of follow-up were assigned to Group 1. This group included 70.5% of the authors' patients. Group 2 included patients who complained of a slight ventrolateral pain at commencement of stressing, though the pain eased distinctly after a few months. This applied to 23.9% of the patients studied. Patients in Group 3 complain immediately postoperatively of a severe, persistent pain at rest, which becomes even more intense when they attempt to put weight on the joint. This group included 5.6% of the authors' patients. Computerized tomographic studies enable morphologic changes in the compacta, i.e., atrophy, to be detected with greater accuracy. If such atrophy-which is tantamount to loosening of the prosthesis-occurs, it is a sign that the impact of the prosthesis on the diaphysis is too hard. This results in pathologic border stresses, as a consequence of which paradoxical bone resorption occurs. As a rule, these prostheses have to be changed; conservative treatment is not possible.
Naumann
T
T
II. Orthopäd, Klinik Augsburg.
Buchner
F
F
Eckardt
V
V
D000368:Aged; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging*; D005500:Follow-Up Studies; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000145:classification*; D011183:Postoperative Complications / Q000145:classification* / Q000000981:diagnostic imaging; D011474:Prosthesis Design; D011475:Prosthesis Failure; D014057:Tomography, X-Ray Computed
Der Oberschenkelschmerz nach Zweymüller-TEP: Computertomografische Untersuchungen über das morphologische Verhalten des metadiaphysären Femur.