Clinical relevance of acetabular erosion in young patients with a bipolar hip prosthesis

In elderly patients bipolar hip prostheses are often used for intracapsular fractures of the femoral neck and are often complicated by pain after a few years; this pain is frequently related to acetabular erosion seen on xray. In this study 18 bipolar hip prostheses were used in the treatment of a proximal femoral sarcoma in a young patient population (mean age: 39.6 years). Their quality of life was evaluated by TESS and MSTS scores, after a mean follow-up of 81.8 months (range 8-171 months). A radiologic grading system was used to assess acetabular erosion on plain xrays. The patients did not report significant pain, they enjoyed a very good quality of life, and they did not show any obvious acetabular erosion. The use of a bipolar implant appears as a good alternative to total hip replacement in the treatment of relatively young patients who have to undergo proximal femoral tumor resection procedures and have a normal acetabulum.