[Cement-free hip endoprosthesis: PCA shaft prosthesis, 5-7-year results]

73 patients (out of a total of 79) with altogether 87 PCA-stems were followed up 5 to 7 years after total hip arthroplasty. The cups combined in these operations were not part of this study. In 11% the PCA-stem had to be removed respectively changed because of loosening. 50% of all patients suffered from thigh pain during the first 6 months postoperatively. Generally this pain disappeared within the first year after operation. Nevertheless 40% reported periods of transient thigh pain after the first postoperative year. Only when this pain was increasing and persisting over months, a correlation to loosening of the stem was found. Subsidence of more than 4 mm after the first postoperative year proved to be the only confident radiological sign of loosening. A strong correlation however was also found between appearance of a continuous radiolucent line through the zones 3-5 (according to Gruen) and loosening. We conclude that PCA-stems to our experience are not satisfactory because of the relatively high rate of loosening as well as the frequent occurring of transient thigh pain, even if this has not to be regarded as a sign of loosening.