Biomechanical analysis and quantitative analysis of bone scintigraphy on thrust plate hip prosthesis

Introduction. To study the load distribution of the thrust plate hip prosthesis (TPP, Sulzer Medica, Baar, Switzerland) on femoral bone, a TPP insertion group and intramedullary cemented stem insertion group were prepared with the use of embalmed femoral anatomic specimens, and strain on the femoral bone induced by loading was measured. Materials and methods. Bone scintigraphy was performed in 26 joints which underwent total hip arthroplasty with the use of TPP, to enable quantitative evaluation of postoperative remodeling of the bone. Results. In the TPP insertion group, the strain was almost equivalent to that in the untreated femoral control group. On the other hand, compared with the control group and TPP insertion group, strain in the proximal portion of the femoral bone (medial side of the femoral neck) was significantly smaller in the cemented stem group (control group versus cemented stem insertion group, p=0.0062; cemented stem insertion group versus TPP 130degrees insertion group, p=0.0005; cemented stem insertion group versus TPP 140degrees insertion group, p=0.0031). Bone scintigrams revealed decreased uptake at 12 weeks after operation compared with 6 weeks after operation, indicating that TPP allows earlier implant stabilization than the conventional stem. Conclusion. Compared with the conventional stem, TPP is a prosthesis that can perform physiological load transmission.