PMC5479952_01
Initial (a) anteroposterior and (b) lateral radiographs of the right hip showed osteoarthritis with joint space narrowing and collapse of the weight-bearing surface of the femoral head (stage 4, Association Research Circulation Osseous [ARCO] staging system).
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A 44-year-old woman (body mass index, 24.1 kg/m2) with alcohol-associated osteonecrosis of the right femoral head (stage 4, Association Research Circulation Osseous staging system) underwent THA with the use of a TPP at our hospital (Fig. 1, Fig. 2).
(a) Anteroposterior and (b) lateral radiographs at the time of total hip arthroplasty (THA) with the thrust plate hip prosthesis (TPP). The insertion angle of the thrust plate to the femoral axis was 130  on the postoperative anteroposterior radiograph.
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The thrust plate was inserted at a femoral shaft-neck angle of 130  on an anteroposterior radiograph, which is reportedly the optimal insertion angle (Fig. 2a).
(a) Anteroposterior and (b) lateral radiographs of right hip at the time of periprosthetic femoral fracture 13 years after the primary THA using a TPP. A displaced subtrochanteric fracture was seen below the distal tip of the lateral plate. Implant loosening was not observed around the medical cortex of the proximal femur.
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She returned to our hospital where a plain radiograph showed a displaced subtrochanteric fracture of the right femur below the distal tip of the lateral plate without implant loosening (Fig. 3), which was classified as a type B1 fracture according to Vancouver categories.
(a) Anteroposterior and (b) lateral radiographs of the right hip after the revision surgery. The long distally fixed intramedullary stem was used in conjunction with a plate and cable system to obtain sufficient stability of the fracture sites.
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Plate; Zimmer, Warsaw, IN, USA) (Fig. 4). Partial weight-bearing walking was permitted 4 weeks after surgery, and full weight-bearing walking was initiated 2 months later.