Uncemented total hip replacements and thigh pain.

We reviewed 51 uncemented total hip replacements (THRs) in 44 patients (mean age 62 years) and average postoperative follow-up period of 4 years. The evaluation system used was based on that of D'Aubigne-Postel-Charnley, and the excellent and very good results totalled over 90%. There were no revisions or aseptic loosenings, and only one late infection and one death due to cardiac infarction. Special attention was paid to the so-called thigh pain phenomenon which, despite current views, was found to be unexpectedly low (only one case) and also gone within 2 years. We feel that the design of the prosthesis used, its kind of alloy, the anatomic shape of the stem and the low modulus of the elasticity as well as the avoidance of the press fitting technique at the distal part of the stem are important factors in avoiding the stress shielding phenomenon and thigh pain.