Total hip arthroplasty in young patients using the thrust plate prosthesis: clinical and radiological results.
BACKGROUND
The standard treatment for patients who require total hip replacement is the implantation of an intramedullary diaphyseal anchored hip prosthesis. A bone-sparing thrust plate hip prosthesis (TPP) can be used as an alternative device for young patients. The TPP relies on proximal femoral metaphyseal fixation. The theoretical advantage of leaving diaphyseal bone intact is easier conversion to a stemmed prosthesis. This retrospective study evaluated the medium- and short-term results after total joint replacement using the third generation TPP.


METHODS
Between 1997 and 2001, 58 TPPs were used for 52 patients. Clinical and demographic data were obtained from the patients' charts and our electronic database. Their average age at time of surgery was 40.9+/-11.4 years. At follow-up, the Harris hip score, residual pain, required pain medication, and the ability to lie on the operated side were documented. Radiographic evaluation included standardized radiographs of the hip joint and the pelvis.


RESULTS
Four patients required revision surgery (6.9%). For 51 of the remaining 54 TPPs, a postoperative functional and radiological status was obtained. The average follow-up was 26+/-11.0 months. 88% of the patients experienced some or complete relief of pain. The median Harris hip score at follow-up was 73+/-20.5 points. A postoperative hip dislocation occurred in 5 patients (8.6%).


CONCLUSIONS
Since many patients experienced some or complete relief of pain, the TPP can be recommended as a feasible implant for the treatment of hip disorders requiring total hip arthroplasty in young patients. Revision surgeries are facilitated by the good bone stock remaining in the proximal femur.
Zelle
Boris A
BA
Department of Trauma Surgery, Hannover Medical School, Hannover, Germany. zelleba@msx.upmc.edu
Gerich
Torsten G
TG
Bastian
Leonard
L
Shuler
Franklin D
FD
Pape
Hans-Christoph
HC
Krettek
Christian
C
D000328:Adult; D019644:Arthroplasty, Replacement, Hip; D005260:Female; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D015207:Osteoarthritis, Hip / Q000000981:diagnostic imaging / Q000601:surgery*; D010147:Pain Measurement; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation; D016896:Treatment Outcome