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Clinical Orthopaedics and Related Research®
Published in: Clinical Orthopaedics and Related Research® 9/2009

01-09-2009 | Symposium: Papers Presented at the Annual Closed Meeting of the International Hip Society

Survival of the Cementless Spotorno® Stem in the Second Decade

Authors: Peter R. Aldinger, MD, PhD, Alexander W. Jung, MD, Steffen J. Breusch, MD, PhD, Volker Ewerbeck, MD, PhD, Dominik Parsch, MD, PhD

Published in: Clinical Orthopaedics and Related Research® | Issue 9/2009

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Abstract

High survival rates have been reported for the uncemented CLS® Spotorno® stem up to 10 years. To confirm survival at longer followup we report the minimum 15-year (mean, 17 years; range, 15–20 years) for 257 hips using this stem. We retrospectively evaluated the clinical and radiographic results of all 326 patients (354 THAs) operated between 1985 and 1989. The patients had a mean age of 57 years using an uncemented grit-blasted, tapered titanium femoral stem. Eighty-six patients (89 hips) died and eight patients (eight hips) were lost to followup, leaving 240 patients (257 hips) for evaluation. The femoral component was revised in 35 hips: eight for infection, nine for periprosthetic fracture, one for traumatic loosening, and 17 for aseptic loosening. Survival of the stem was 88% at 17 years (95% confidence interval, 84%–92%), and survival with femoral revision for aseptic loosening as an end point was 94% (95% confidence interval, 91%–97%). The median Harris hip score at followup was 80 points. No thigh pain was reported. Small osteolytic lesions (< 1 cm2) were found in the proximal Gruen zones (1 or/and 7) in 28 hips (15%). No distal femoral osteolysis was found. The long-term survival with this type of femoral component remains high in the second decade.
Level of Evidence: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
Literature
1.
Aldinger PR, Breusch SJ, Lukoschek M, Mau H, Ewerbeck V, Thomsen M. A ten- to 15-year follow-up of the cementless Spotorno stem. J Bone Joint Surg Br. 2003;85:209–214.PubMedCrossRef
2.
Aldinger PR, Sabo D, Pritsch M, Thomsen M, Mau H, Ewerbeck V, Breusch SJ. Pattern of periprosthetic bone remodeling around stable uncemented tapered hip stems: a prospective 84-month follow-up study and a median 156-month cross-sectional study with DXA. Calcif Tissue Int. 2003;73:115–121.PubMedCrossRef
3.
Aldinger PR, Thomsen M, Lukoschek M, Mau H, Ewerbeck V, Breusch SJ. Long-term fate of uncemented, threaded acetabular components with smooth surface treatment: minimum 10-year follow-up of two different designs. Arch Orthop Trauma Surg. 2004;124:469–475.PubMedCrossRef
4.
Aldinger PR, Thomsen M, Mau H, Ewerbeck V, Breusch SJ. Cementless Spotorno tapered titanium stems: excellent 10-15-year survival in 141 young patients. Acta Orthop Scand. 2003;74:253–258.PubMedCrossRef
5.
Bauer R, Kerschbaumer F, Poisel S, Oberthaler W. The transgluteal approach to the hip joint. Arch Orthop Trauma Surg. 1979;95:47–49.PubMedCrossRef
6.
Belmont PJ Jr, Powers CC, Beykirch SE, Hopper RH Jr, Engh CA Jr, Engh CA. Results of the anatomic medullary locking total hip arthroplasty at a minimum of twenty years: a concise follow-up of previous reports. J Bone Joint Surg Am. 2008;90:1524–1530.PubMedCrossRef
7.
Bojescul JA, Xenos JS, Callaghan JJ, Savory CG. Results of porous-coated anatomic total hip arthroplasty without cement at fifteen years: a concise follow-up of a previous report. J Bone Joint Surg Am. 2003;85:1079–1083.PubMed
8.
Britton A, Murray D, Bulstrode C, McPherson K, Denham R. Loss to follow-up: does it matter? Lancet. 1995;345:1511–1512.PubMedCrossRef
9.
Callaghan JJ, Liu SS, Firestone DE, Yehyawi TM, Goetz DD, Sullivan J, Vittetoe DA, O’Rourke MR, Johnston RC. Total hip arthroplasty with cement and use of a collared matte-finish femoral component: nineteen to twenty-year follow-up. J Bone Joint Surg Am. 2008;90:299–306.PubMedCrossRef
10.
Charnley J. The long-term results of low-friction arthroplasty of the hip performed as a primary intervention. J Bone Joint Surg Br. 1972;54:61–76.PubMed
11.
Ellison B, Berend KR, Lombardi AV, Jr., Mallory TH. Tapered titanium porous plasma-sprayed femoral component in patients aged 40 years and younger. J Arthroplasty. 2006;21:32–37.PubMedCrossRef
12.
Engh CA, Bobyn JD, Glassman AH. Porous-coated hip replacement: the factors governing bone ingrowth, stress shielding, and clinical results. J Bone Joint Surg Br. 1987;69:45–55.PubMed
13.
Engh CA Jr, Claus AM, Hopper RH Jr, Engh CA. Long-term results using the anatomic medullary locking hip prosthesis. Clin Orthop Relat Res. 2001;393:137–146.PubMedCrossRef
14.
Engh CA Jr, Culpepper WJ 2nd, Engh CA. Long-term results of use of the anatomic medullary locking prosthesis in total hip arthroplasty. J Bone Joint Surg Am. 1997;79:177–184.PubMedCrossRef
15.
Eskelinen A, Remes V, Helenius I, Pulkkinen P, Nevalainen J, Paavolainen P. Uncemented total hip arthroplasty for primary osteoarthritis in young patients: a mid-to long-term follow-up study from the Finnish Arthroplasty Register. Acta Orthop. 2006;77:57–70.PubMedCrossRef
16.
Fowler JL, Gie GA, Lee AJ, Ling RS. Experience with the Exeter total hip replacement since 1970. Orthop Clin North Am. 1988;19:477–489.PubMed
17.
Grant P, Nordsletten L. Total hip arthroplasty with the Lord prosthesis: a long-term follow-up study. J Bone Joint Surg Am. 2004;86:2636–2641.PubMed
18.
Grubl A, Chiari C, Giurea A, Gruber M, Kaider A, Marker M, Zehetgruber H, Gottsauner-Wolf F. Cementless total hip arthroplasty with the rectangular titanium Zweymuller stem: a concise follow-up, at a minimum of fifteen years, of a previous report. J Bone Joint Surg Am. 2006;88:2210–2215.PubMedCrossRef
19.
Gruen TA, McNeice GM, Amstutz HC. “Modes of failure” of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop Relat Res. 1979;141:17–27.PubMed
20.
Hallan G, Lie SA, Furnes O, Engesaeter LB, Vollset SE, Havelin LI. Medium- and long-term performance of 11,516 uncemented primary femoral stems from the Norwegian arthroplasty register. J Bone Joint Surg Br. 2007;89:1574–1580.PubMedCrossRef
21.
Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am. 1969;51:737–755.PubMed
22.
Ihle M, Mai S, Pfluger D, Siebert W. The results of the titanium-coated RM acetabular component at 20 years: a long-term follow-up of an uncemented primary total hip replacement. J Bone Joint Surg Br. 2008;90:1284–1290.PubMedCrossRef
23.
Kelley SS, Fitzgerald RH Jr, Rand JA, Ilstrup DM. A prospective randomized study of a collar versus a collarless femoral prosthesis. Clin Orthop Relat Res. 1993;294:114–122.PubMed
24.
Kim YH. Long-term results of the cementless porous-coated anatomic total hip prosthesis. J Bone Joint Surg Br. 2005;87:623–627.PubMedCrossRef
25.
Lewthwaite SC, Squires B, Gie GA, Timperley AJ, Ling RS. The Exeter Universal hip in patients 50 years or younger at 10–17 years’ followup. Clin Orthop Relat Res. 2008;466:324–331.PubMedCrossRef
26.
Lombardi AV Jr, Berend KR, Mallory TH. Hydroxyapatite-coated titanium porous plasma spray tapered stem: experience at 15 to 18 years. Clin Orthop Relat Res. 2006;453:81–85.PubMedCrossRef
27.
Lombardi AV Jr, Berend KR, Mallory TH, Skeels MD, Adams JB. Survivorship of 2000 tapered titanium porous plasma-sprayed femoral components. Clin Orthop Relat Res. 2009;467:146–154.PubMedCrossRef
28.
Martinez de Aragon JS, Keisu KS. 21-year results of the uncemented fully textured lord hip prosthesis. Clin Orthop Relat Res. 2007;454:133–138.PubMedCrossRef
29.
McAuley JP, Szuszczewicz ES, Young A, Engh CA Sr. Total hip arthroplasty in patients 50 years and younger. Clin Orthop Relat Res. 2004;418:119–125.PubMedCrossRef
30.
McLaughlin JR, Lee KR. The outcome of total hip replacement in obese and non-obese patients at 10- to 18-years. J Bone Joint Surg Br. 2006;88:1286–1292.PubMedCrossRef
31.
McLaughlin JR, Lee KR. Total hip arthroplasty with an uncemented tapered femoral component. J Bone Joint Surg Am. 2008;90:1290–1296.PubMedCrossRef
32.
Meding JB, Ritter MA, Keating EM, Faris PM. Clinical and radiographic evaluation of long-stem femoral components following revision total hip arthroplasty. J Arthroplasty. 1994;9:399–408.PubMedCrossRef
33.
Ochs U, Eingartner C, Volkmann R, Ochs BG, Huber C, Weller S, Weise K. Prospective long-term follow-up of the cementless bicontact hip stem with plasmapore coating. Z Orthop Unfall. 2007;145(Suppl 1):S3–S8.PubMedCrossRef
34.
Parsch D, Jung AW, Thomsen M, Ewerbeck V, Aldinger PR. Good survival of uncemented tapered stems for failed intertrochanteric osteotomy: a mean 16 year follow-up study in 45 patients. Arch Orthop Trauma Surg. 2008;128:1081–1085.PubMedCrossRef
35.
Parvizi J, Keisu KS, Hozack WJ, Sharkey PF, Rothman RH. Primary total hip arthroplasty with an uncemented femoral component: a long-term study of the Taperloc stem. J Arthroplasty. 2004;19:151–156.PubMedCrossRef
36.
Parvizi J, Sharkey PF, Hozack WJ, Orzoco F, Bissett GA, Rothman RH. Prospective matched-pair analysis of hydroxyapatite-coated and uncoated femoral stems in total hip arthroplasty: a concise follow-up of a previous report. J Bone Joint Surg Am. 2004;86:783–786.PubMedCrossRef
37.
Parvizi J, Sullivan T, Duffy G, Cabanela ME. Fifteen-year clinical survivorship of Harris-Galante total hip arthroplasty. J Arthroplasty. 2004;19:672–677.PubMedCrossRef
38.
Rajaratnam SS, Jack C, Tavakkolizadeh A, George MD, Fletcher RJ, Hankins M, Shepperd JA. Long-term results of a hydroxyapatite-coated femoral component in total hip replacement: a 15- to 21-year follow-up study. J Bone Joint Surg Br. 2008;90:27–30.PubMed
39.
Reigstad A, Rokkum M, Bye K, Brandt M. Femoral remodeling after arthroplasty of the hip: prospective randomized 5-year comparison of 120 cemented/uncemented cases of arthrosis. Acta Orthop Scand. 1993;64:411–416.PubMedCrossRef
40.
Reigstad O, Siewers P, Rokkum M, Espehaug B. Excellent long-term survival of an uncemented press-fit stem and screw cup in young patients: follow-up of 75 hips for 15–18 years. Acta Orthop. 2008;79:194–202.PubMedCrossRef
41.
Sathappan SS, Ginat D, Patel V, Walsh M, Jaffe WL, Di Cesare PE. Effect of anesthesia type on limb length discrepancy after total hip arthroplasty. J Arthroplasty. 2008;23:203–209.PubMedCrossRef
42.
Schramm M, Keck F, Hohmann D, Pitto RP. Total hip arthroplasty using an uncemented femoral component with taper design: outcome at 10-year follow-up. Arch Orthop Trauma Surg. 2000;120:407–412.PubMedCrossRef
43.
Siebold R, Scheller G, Schreiner U, Jani L. Long-term results with the cement-free Spotorno CLS shaft [in German]. Orthopade. 2001;30:317–322.PubMedCrossRef
44.
Simank HG, Brocai DR, Reiser D, Thomsen M, Sabo D, Lukoschek M. Middle-term results of threaded acetabular cups: high failure rates five years after surgery. J Bone Joint Surg Br. 1997;79:366–370.PubMedCrossRef
45.
Singh M, Nagrath AR, Maini PS. Changes in trabecular pattern of the upper end of the femur as an index of osteoporosis. J Bone Joint Surg Am. 1970;52:457–467.PubMed
46.
Slack R, Tindall A, Shetty AA, James KD, Rand C. 15-year follow-up results of the hydroxyapatite ceramic-coated femoral stem. J Orthop Surg (Hong Kong). 2006;14:151–154.
47.
Smith SE, Estok DM 2nd, Harris WH. 20-year experience with cemented primary and conversion total hip arthroplasty using so-called second-generation cementing techniques in patients aged 50 years or younger. J Arthroplasty. 2000;15:263–273.PubMedCrossRef
48.
Spotorno L, Romagnoli S, Ivaldo N, Grappiolo G, Bibbiani E, Blaha DJ, Guen TA. The CLS system: theoretical concept and results. Acta Orthop Belg. 1993;59(Suppl 1):144–148.PubMed
49.
Suckel A, Geiger F, Kinzl L, Wulker N, Garbrecht M. Long-term results for the uncemented Zweymuller/Alloclassic hip endoprosthesis: a 15-year minimum follow-up of 320 hip operations. J Arthroplasty. 2008 Sep 11. [Epub ahead of print].
50.
Teloken MA, Bissett G, Hozack WJ, Sharkey PF, Rothman RH. Ten to fifteen-year follow-up after total hip arthroplasty with a tapered cobalt-chromium femoral component (tri-lock) inserted without cement. J Bone Joint Surg Am. 2002;84:2140–2144.PubMed
51.
Vervest TM, Anderson PG, Van Hout F, Wapstra FH, Louwerse RT, Koetsier JW. Ten to twelve-year results with the Zweymuller cementless total hip prosthesis. J Arthroplasty. 2005;20:362–368.PubMedCrossRef
52.
Willert HG, Bertram H, Buchhorn GH. Osteolysis in alloarthroplasty of the hip: the role of ultra-high molecular weight polyethylene wear particles. Clin Orthop Relat Res. 1990;258:95–107.PubMed
53.
Yoon TR, Rowe SM, Kim MS, Cho SG, Seon JK. Fifteen- to 20-year results of uncemented tapered fully porous-coated cobalt-chrome stems. Int Orthop. 2008;32:317–323.PubMedCrossRef
Metadata
Title
Survival of the Cementless Spotorno® Stem in the Second Decade
Authors
Peter R. Aldinger, MD, PhD
Alexander W. Jung, MD
Steffen J. Breusch, MD, PhD
Volker Ewerbeck, MD, PhD
Dominik Parsch, MD, PhD
Publication date
01-09-2009
Publisher
Springer-Verlag
Published in
Clinical Orthopaedics and Related Research® / Issue 9/2009
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-009-0906-7

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