Anatomic cementless total hip replacement: design considerations and early clinical experience.

One hundred and two uncemented total hip arthroplasties using an anatomic femoral component were performed and followed postoperatively in 96 patients for an average of 35 months (range 24-44). Clinical assessment was performed by a Harris Hip Score (HHS) and standardized radiographs. The primary diagnoses were: osteoarthritis, 86 patients; traumatic arthritis 2; inflammatory arthritis 2; congenital hip dysplasia 5 and avascular necrosis 1. There were 44 males and 52 females. The purpose of this study was to prospectively study whether anatomically designed cementless femoral stems reduce the incidence of thigh pain and limp in the early period after total hip arthroplasty. The average pre-operative HHS was 47, the average pain score was 16 and average function score 25. At the last follow-up the average HHS was 93, average pain and limp at one year was 3.5% and was only slight to mild; this decreased to 1.9% at last follow-up. Radiographic findings included calcar rounding 75%, pedestal formation 40%, distal cortical hypertrophy 20% and incomplete radiolucencies in 35%. No endosteal erosions were seen. Heterotopic ossifications were present in 2 patients, one of which required excision. Complications consisted of dislocations treated closed, 3 intra-operative fractures without sequellae, 1 traumatic peri-operative fracture which required surgery without further complication and 1 pulmonary embolism. One patient required revision for leg length discrepancy. There were no infections. The results of this study indicate that this cementless, anatomically designed femoral component can provide satisfactory, early pain relief and function in this younger, active patient population.(ABSTRACT TRUNCATED AT 250 WORDS)