Thigh pain despite bone ingrowth into uncemented femoral stems,”The

Six porous-coated, uncemented femoral components were revised at a mean of34.5 months for persistent thigh pain. At operation the stems were rigidly stable, difficult to extract, and showed good bony ingrowth. The four men and two women, with an average age of 59 years, all had thigh pain starting within the first year, progressive over time and unresponsive to conservative measures. These cases show that rigid fixation with good bony ingrowth does not guarantee the clinical success of a porous-coated uncemented femoral stem. Porous-coated uncemented femoral stems rely on tissue ingrowth to achieve stability (Haddad, Cook and Thomas 1987). The presumption is that good bone ingrowth will provide rigid fixation and clinical success (Engh, Bobyn and Glassman 1987), but it is now recognised that a significant percentage of patients have persistent thigh pain and limping after uncemented hip replacement (Engh et al 1987; Callaghan, Dysart and Savory 1988; Campbell et al 1992). Residual pain has been reported i