title: Thigh pain in cementless total hip arthroplasty. A comparison of two systems at 2 years' follow-up.
abstract: Cementless total hip arthroplasties using 110 porous-coated anatomic (PCA) and 105 consecutive Mallory-Head (MH) prostheses were reviewed using prospectively gathered clinical data and a detailed radiographic analysis. In an earlier experience with the PCA, 13% of patients experienced thigh pain at 1 year and 23% at 2 years. Positive radiographic correlates with thigh pain included subsidence, distal cortical hypertrophy, a tight diaphyseal fit, and stem tip sclerosis. In the current MH study group, the incidence of thigh pain was 7% at 1 year and 3% at 2 years. No radiographic findings correlated positively with thigh pain. The results of this short-term clinical comparison suggest that a long, straight, tapered design offered better initial stability than its anatomic counterpart as reflected in the much lower incidence of thigh pain. These results may translate into improved osseous integration and long-term success.
authors.affiliation: Department of Orthopaedics, University of Calgary, Alberta, Canada.
authors.forename: B C
authors.initials: BC
authors.lastname: Burkart
authors.forename: R B
authors.initials: RB
authors.lastname: Bourne
authors.forename: C H
authors.initials: CH
authors.lastname: Rorabeck
authors.forename: P G
authors.initials: PG
authors.lastname: Kirk
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005269:Femur / Q000473:pathology; D005500:Follow-Up Studies; D006622:Hip Prosthesis / Q000295:instrumentation / Q000379:methods; D006801:Humans; D006984:Hypertrophy; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D011446:Prospective Studies; D011474:Prosthesis Design; D011859:Radiography; D013848:Thigh; D013997:Time Factors