Abstract
Background
The thrust plate prosthesis is an implant with a metaphyseal fixation at the proximal femur that transmits the load forces of the hip onto the femoral neck.
Methods
In this prospective study, 15 patients (8 women, 7 men) with 19 cementless thrust plate prostheses because of femoral head necrosis were examined. A clinical and radiologic evaluation was performed preoperatively, at 3, 6, 12, 18, and 24 months postoperatively, and every year thereafter. The mean follow-up period was 44 (range, 24–72) months. The average age at the time of surgery was 49 (27–70) years. The pathogenesis of femoral head necrosis included alcoholism (6 joints of 3 cases), Gaucher disease (1 joint of 1 case), Sheehan syndrome (2 joints of 1 case), and idiopathic (10 joints of 10 cases).
Results
The Harris hip score increased from 53 (range, 15–71) to 97 (92–100) points on the final evaluation. Although mean preoperative hip flexion and abduction were 78° (45°–110°) and 24° (10°–45°), respectively, these increased to 114° (75°–125°) and 47° (45°–50°) 12 months after surgery and remained stable up to the latest follow-up. None of the patients displayed mechanical problems, and revision was not necessary in any case.
Conclusions
The thrust plate prosthesis shows midterm results comparable to those of the cementless stemmed prosthesis and supplies advantages, especially for younger patients with femoral head necrosis, because of its metaphyseal bone-preserving fixation.
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References
Y Yasunaga T Hisatome Y Ikuta S Nakamura (2001) ArticleTitleA histological study of the necrotic area after transtrochanteric anterior rotational osteotomy for osteonecrosis of the femoral head J Bone Joint Surg [Br] 83 167–70 10.1302/0301-620X.83B2.11503 Occurrence Handle10.1302/0301-620X.83B2.11503 Occurrence Handle1:STN:280:DC%2BD3M3hslGisQ%3D%3D
MA Mont DS Hungerford (1995) ArticleTitleCurrent concepts review: non-traumatic avascular necrosis of the femoral head J Bone Joint Surg [Am] 77 459–74 Occurrence Handle1:STN:280:DyaK2M7pslOjsw%3D%3D
A Sarmiento E Ebramzadeh WJ Gogan HA McKellop (1990) ArticleTitleTotal hip arthroplasty with cement: a long-term radiographic analysis in patients who are older than fifty and younger than fifty years J Bone Joint Surg [Am] 72 1470–6 Occurrence Handle1:STN:280:DyaK3M%2Fnt1ChtA%3D%3D
CJ Ortiguera IT Pulliam ME Cabanela (1999) ArticleTitleTotal hip arthroplasty for osteonecrosis: matched-pair analysis of 188 hips with long-term follow-up J Arthroplasty 14 21–8 10.1016/S0883-5403(99)90197-3 Occurrence Handle10.1016/S0883-5403(99)90197-3 Occurrence Handle1:STN:280:DyaK1M7isVWgug%3D%3D Occurrence Handle9926948
AH Huggler HA Jacob H Bereiter M Haferkorn C Ryf R Schenk (1993) ArticleTitleLong-term results with the uncemented thrust plate prosthesis (TPP) Acta Orthop Belg (suppl 1) 59 215–23
Y Gürsoy I Günal S Aksoy T Sarioglu N Köse (1996) ArticleTitleStrain distribution in the proximal femora. Comparison of intra and extramedullary type prostheses with intact bone Artroplasti Artroskopik Cerrahi (Arthroplasty Arthroscopic Surg) 7 24–8
H Bereiter M Bürgi R Schenk (1997) Finite element investigations of the proximal femur after implantation of the thrust plate prosthesis compared with findings in a post-mortem histological specimen and in radiological follow-up examinations AH Huggler HAC Jacob (Eds) The thrust plate prosthesis Springer Berlin 48–62
HAC Jacob (1997) Biomechanical principles and design details of the thrust plate prosthesis AH Huggler HAC Jacob (Eds) The thrust plate prosthesis Springer Berlin 25–47
RK Schenk R Hauser AH Huggler HAC Jacob (1997) Histology of the thrust plate–bone interface AH Huggler HAC Jacob (Eds) The thrust plate prosthesis Springer Berlin 63–73
M Menge (1997) Bone remodelling of the proximal femur after implantation of a thrust plate prosthesis AH Huggler HAC Jacob (Eds) The thrust plate prosthesis Springer Berlin 98–106
B Fink C Siegmüller T Schneider S Conrad G Schmielau W Ruther (2000) ArticleTitleShort- and medium-term results of the thrust plate prosthesis in patients with polyarthritis Arch Orthop Trauma Surg 120 294–8 10.1007/s004020050468 Occurrence Handle10.1007/s004020050468 Occurrence Handle1:STN:280:DC%2BD3cvpt1Wntw%3D%3D Occurrence Handle10853899
W Steens D Rosenbaum C Goetze G Gosheger R van den Daele J Steinbeck (2003) ArticleTitleClinical and functional outcome of the thrust plate prosthesis: short- and medium-term results Clin Biomech 18 647–54 10.1016/S0268-0033(03)00092-5 Occurrence Handle10.1016/S0268-0033(03)00092-5 Occurrence Handle1:STN:280:DC%2BD3szkvVKhug%3D%3D
BA Zelle TG Gerich L Bastian FD Shuler HC Pape C Krettek (2004) ArticleTitleTotal hip arthroplasty in young patients using the thrust plate prosthesis: clinical and radiological results Arch Orthop Trauma Surg 124 310–6 10.1007/s00402-004-0652-y Occurrence Handle10.1007/s00402-004-0652-y Occurrence Handle15085357
B Fink T Schneider S Conrad M Jaeger M Protzen W Rüther (2002) ArticleTitleThe thrust plate prosthesis in patients with aseptic osteonecrosis of the femoral head Arch Orthop Trauma Surg 122 499–505 Occurrence Handle12580186
Y Yasunaga T Goto T Hisatome R Tanaka T Yamasaki M Ochi (2003) ArticleTitleBone-preserving prosthesis with a single axis for treating osteonecrosis of the femoral head: midterm results for the thrust plate hip prosthesis J Orthop Sci 8 818–22 10.1007/s00776-003-0710-2 Occurrence Handle10.1007/s00776-003-0710-2 Occurrence Handle14648271
B Unver V Karatosun I Gunal S Angin (2004) ArticleTitleComparison of two different rehabilitation programmes for thrust plate prosthesis: a randomized controlled study Clin Rehabil 18 84–91 10.1191/0269215504cr705oa Occurrence Handle10.1191/0269215504cr705oa Occurrence Handle14763723
Z Gocen A Sen B Unver V Karatosun I Gunal (2004) ArticleTitleThe effect of preoperative physiotherapy and education on the outcome of total hip replacement: a prospective randomized controlled trial Clin Rehabil 18 353–8 10.1191/0269215504cr758oa Occurrence Handle10.1191/0269215504cr758oa Occurrence Handle15180117
BN Stulberg AW Davis TW Bauer M Levine K Easley (1991) ArticleTitleOsteonecrosis of the femoral head: a prospective randomized treatment protocol Clin Orthop 268 140–51 Occurrence Handle2060201
JA D’Antonio WN Capello MT Manley J Feinberg (1997) ArticleTitleHydroxyapatite coated implants: total hip arthroplasty in the young patient and patients with avascular necrosis Clin Orthop 344 124–38 10.1097/00003086-199711000-00014 Occurrence Handle9372765
JP Garino ME Steinberg (1997) ArticleTitleTotal hip arthroplasty in patients with avascular necrosis of the femoral head: a 2- to 10-year follow-up Clin Orthop 334 108–15 10.1097/00003086-199701000-00014 Occurrence Handle9005902
MA Fye MH Huo LE Zatorski KJ Keggi (1998) ArticleTitleTotal hip arthroplasty performed without cement in patients with femoral head osteonecrosis who are less than 50 years old J Arthroplasty 13 876–81 10.1016/S0883-5403(98)90193-0 Occurrence Handle10.1016/S0883-5403(98)90193-0 Occurrence Handle1:STN:280:DyaK1M%2FpsVOrug%3D%3D Occurrence Handle9880179
RL Barrack RD Mulroy SuffixJr WH Harris (1992) ArticleTitleImproved cementing techniques and femoral component loosening in young patients with hip arthroplasty. A 12-year radiographic review J Bone Joint Surg [Br] 74 385–9 Occurrence Handle1:STN:280:DyaK383mvVWlug%3D%3D
BN Stulberg R Singer J Goldner J Stulberg (1997) ArticleTitleUncemented total hip arthroplasty in osteonecrosis: a 2- to 10-year evaluation Clin Orthop 334 116–23 10.1097/00003086-199701000-00015 Occurrence Handle9005903
GP Duffy DJ Berry C Rowland ME Cabanela (2001) ArticleTitlePrimary uncemented total hip arthroplasty in patients <40 years old: 10- to 14-year results using first-generation proximally porous-coated implants J Arthroplasty (suppl 1) 16 140–4 10.1054/arth.2001.28716 Occurrence Handle1:STN:280:DC%2BD3MjgtFSktg%3D%3D
JD Crowther PF Lachiewicz (2002) ArticleTitleSurvival and polyethylene wear of porous coated acetabular components in patients less than fifty years old: results at nine to fourteen years J Bone Joint Surg [Am] 84 729–35 Occurrence Handle10.1302/0301-620X.84B5.12741
JR McLaughlin KR Lee (2000) ArticleTitleTotal hip arthroplasty in young patients: 8- to 13-year results using an uncemented stem Clin Orthop 373 153–63 10.1097/00003086-200004000-00019 Occurrence Handle10.1097/00003086-200004000-00019 Occurrence Handle10810473
DK Collis (1984) ArticleTitleCemented total hip replacement in patients who are less than fifty years old J Bone Joint Surg [Am] 66 353–9 Occurrence Handle1:STN:280:DyaL2c7jsFyquw%3D%3D
CH Shih WP Chen CL Tai RF Kuo CC Wu CH Chen (1997) ArticleTitleNew concepts — biomechanical studies of a newly designed femoral prosthesis (cervicotrochanter prosthesis) Clin Biomech 12 482–90 10.1016/S0268-0033(97)00032-6 Occurrence Handle10.1016/S0268-0033(97)00032-6
T Goto Y Yasunaga K Takahashi M Ochi (2004) ArticleTitleBiomechanical analysis and quantitative analysis of bone scintigraphy on thrust plate hip prosthesis Arch Orthop Trauma Surg 124 357–62 Occurrence Handle15108008
B Unver V Karatosun I Gunal (2005) ArticleTitleAssessing the results of thrust plate prosthesis: a comparison of four different rating systems Clin Rehabil 19 654–8 10.1191/0269215505cr868oa Occurrence Handle10.1191/0269215505cr868oa Occurrence Handle16180601
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Karatosun, V., Gunal, I., Unver, B. et al. Thrust plate prosthesis for osteonecrosis of the femoral head: short-term results of 15 patients followed 2–6 years. J Orthop Sci 11, 450–453 (2006). https://doi.org/10.1007/s00776-006-1053-6
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DOI: https://doi.org/10.1007/s00776-006-1053-6