FEMORAL COMPONENT FIXATION WITH AND WITHOUT INTRAMEDULLARY PLUG - A 6-YEAR FOLLOW-UP

A total of 113 patients underwent a cemented total hip replacement (TH R) operation involving femoral component fixation either without the u se of a distal intramedullary plug: (n = 57, group 1) or with the plug (n = 56, group 2). We studied the femoral component fixation radiogra phically at on average 6 years after THR. The cement coating was asses sed as technically good in 86% and 95% of groups 1 and 2, respectively . There was radiographically diagnosable loosening of the femoral comp onent at the follow-up in 25 cases in which stems were inserted withou t the intramedullary plug, and in 6 cases in those with the plug (P < 0.0008), and the mean subsidence of the femoral component was 5 mm in group 1 and 1.5 mm (P < 0.0003) in group 2, respectively. Osteolytic c hanges around the femoral component were noticed in both groups in equ al numbers and with no statistical difference. The use of a distal int ramedullary plug in the cementation of the femoral stem results in a b etter cement coating, reduces femoral component subsidence and amelior ates the loosening rates.