A lateralized tapered titanium cementless femoral component does not increase thigh or trochanteric pain

Increased femoral component lateralization has been reported to recreate femoral offset accurately, and should provide better function. Concerns exist that negative effects may occur such as increased thigh pain, trochanteric bursitis, and loosening. The current study aims to examine whether a lateralized femoral component design is associated with increase in thigh pain, trochanteric pain, or implant failure when used to recreate hip soft tissue balance and stability. The authors reviewed 98 total hip arthroplasties (THA) using the Mallory-Head Porous femoral component. Group 1 had 49 consecutive THA performed before the lateralized stem was available. Group 2 had 49 consecutive THA in which lateralization was deemed necessary, based upon preoperative templating and intraoperative soft tissue balancing. Follow up averaged 46 and 38 months, respectively. No stems failed. Group 1 had three dislocations and Group 2 had none with increased offset. Six (12%) patients in Groups 1 and 3 (6%) patients in Group 2 had trochanteric pain (p<0.05). Three (6%) patients had moderate thigh pain in Group 1 and none in Group 2. Significantly less trochanteric and thigh pain was observed in those patients in whom a lateralized stem was deemed necessary. The use of a lateralized stem improves the accuracy of hip soft tissue reconstruction and does not increase thigh pain, trochanteric pain, or loosening. Accurate soft tissue reconstruction may decrease trochanteric and thigh pain and improve function following THA.