Anterior thigh pain after cementless total hip arthroplasty

We compared the incidence of anterior thigh pain retrospectively following primary uncemented total hip replacement in 70 patients (78 hips) with osteoarthritis. In one group (38 hips), an Endoplus porous-coated, canal-filling prosthesis was inserted through an anterolateral approach. In the other group (40 hips), a Furlong hydroxyapatite-coated prosthesis was inserted through a posterior approach. The latter prosthesis has a relatively longer femoral stem and does not achieve diaphyseal press-fit contact. Three patients in the Furlong group had anterior thigh pain, which eventually resolved in two patients. In the Endoplus group, two patients developed anterior thigh pain; in both cases, there was an underlying cause, which had to be treated. Idiopathic anterior thigh pain is more common in non-canal-filling prostheses. When anterior thigh pain is noticed in canal-filling prosthesis, a search for and treatment of the cause will cure the pain. The hydroxyapatite coating did not prevent thigh pain in the Furlong group.