Abstract
Background
Thigh pain following a well-fixed total hip arthroplasty (THA) remains problematic and a source of patient dissatisfaction. The purpose of this study is to evaluate if the development of distal femoral cortical hypertrophy (DFCH) is associated with chronic postoperative thigh pain after THA with a short stem implant.
Methods
All patients who underwent an uncomplicated primary THA via a direct anterior approach with the short stem Taperloc Microplasty® (Zimmer Biomet, Warsaw, IN) implant between 2011 and 2015 were mailed a pain drawing questionnaire. Radiographs were reviewed at 1-year minimum to determine cortical thickness change from immediate post-op. Thigh pain was compared to DFCH as well as patient demographics and femoral stem size. 293 patients were included in the study
Results
Mean follow-up was 3.2 years. A total of 218 hips (74%) had cortical hypertrophy in Gruen zone 3 and 165 hips (56%) had cortical hypertrophy in Gruen zone 5. Fifty-two hips (18%) had ≥25% cortical hypertrophy in zone 3 and 91 hips (31%) had ≥25% cortical hypertrophy in zone 5. A total of 44 patients (15%) reported anterior thigh pain and 43 patients (15%) reported lateral thigh pain. Development of DFCH in either Gruen zone 3 or 5 was not associated with anterior or lateral thigh pain. Stem size was positively correlated with zone 3 hypertrophy and inversely related to zone 5 hypertrophy. Thigh pain was not associated with patient age, gender, activity level or stem size.
Conclusion
The development of distal femoral cortical hypertrophy after THA with a short stem implant was high, but not associated with patient reported anterior or lateral thigh pain.
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