A Study of Thigh Pain Following Cementless Total Hip Arthroplasty

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  • セメントレス人工股関節置換術後の大腿部痛に関する検討

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The cause of thigh pain after cementless total hip arthroplasty (THA) remains unknown. In this study, clinical factors and findings obtained by diagnostic imaging were analyzed in 80 patients who underwent a total of 84 cementless total hip arthroplasties with an avarage postoperative period of 4 years. Proximal fitting (PF) and distal fitting (DF) stem were used. Thigh pain was experienced by 29.8% of the patients, and disappeared within 2 years of THA in 97.6% of these patients. The duration of thigh pain for patients with DF stem was longer than patients with PF stem. The FAI self-evaluation method was used for evaluating clinical factors. The results reveal that the level of physical activity was higher for patients who experienced thigh pain than for those who did not. However, this increase was not found to be statistically significant. Patients who repeatedly performed movements that consistenly resulted in the application of a mechanical load to the operated limb over a long period of time (local shopping, working outdoors over 15min) were more likely to experience thigh pain. On the other hand, the incidence of rarely performed movements that only transiently applied a mechanical load was significantly higher for patients who did not experience thigh pain. It was concluded that suggesting the involvement of the time elements of mechanical loads. From the viewpoint of diagnostic imaging, thigh pain was not seen in patients in whom the proximal stem region was fixed early, but was seen at a significantly high rate in patients with distal femoral sclerosis, suggesting the involvement of micro-movements. Therefore, to prevent thigh pain, it is important to provide appropriate guidance for daily living activities for the first 2 years after surgery, with a particular emphasis on mechanical loads. Also, it is important to use stems that can be fixed to the proximal region of the femur in the early stage.

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