The effect of intramedullary corticocancellous bone plug for hip hemiarthroplasty.

Background: A prospective review was performed on 60 consecutive patients with hip hemiarthroplasty after femoral neck fractures.

Methods: Twenty-two patients underwent Austin Moore hemiarthroplasty with an intramedullary corticocancellous bone plug at the tip of the prosthesis (group A) and 38 patients underwent Austin Moore hemiarthroplasty alone (group B). The patients were evaluated clinically and radiographically at 3 and 6 months postoperatively and annually thereafter.

Results: There was no statistically significant difference in thigh pain score between the two groups. At 3- and 6-month follow-up, 88% and 83% of group A patients experienced no pain or mild thigh pain, compared with 72% and 76% in group B, respectively. The radiographs revealed more stem subsidence and calcar osteolysis in group B than in group A (p < 0.01 and p < 0.05, respectively). Furthermore, in both groups there was a correlation between calcar atrophy, stem subsidence, and early clinical thigh pain score (p < 0.05).

Conclusion: Our data suggest that, whereas the radiologic findings in both groups may be related to thigh pain, they had little effect on the rate of femoral stem revision. We believe that the application of a corticocancellous bone plug in uncemented hip hemiarthroplasty for treatment of femoral neck fractures can decrease the incidence of early thigh pain in the first 6 months.