Distal Femoral Stem Tip Resection for Thigh Pain Complicating Uncemented Total Hip arthroplasty. Five Patients Followed up for 6–10 Years

Abstract

Thigh pain after total hip arthroplasty can be a significant management problem both to patient and surgeon. In many cases, the pain is caused by femoral stem impingement due to its varus position. We present the technique of resection of a segment of distal femoral stem through a minimal incision as treatment of this problem. Five patients with a follow-up of 6 to 10 years are discussed. In all patients thigh pain was explained by the radiographic appearance of the varus stem position and reactive bone formation around the tip of the stem. A bone window was created and resection of the tip of the stem was performed. Four of the patients completely recovered after surgery and one patient, with Paget's disease, required additional interventions due to stress fracture. This is a very simple and effective method of treatment of thigh pain due to femoral stem impingement in healthy bone.