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. 2009 Sep;467(9):2297-304.
doi: 10.1007/s11999-009-0906-7. Epub 2009 Jun 6.

Survival of the cementless Spotorno stem in the second decade

Peter R Aldinger  1 , Alexander W Jung, Steffen J Breusch, Volker Ewerbeck, Dominik Parsch
Affiliations

Survival of the cementless Spotorno stem in the second decade

Peter R Aldinger et al. Clin Orthop Relat Res. 2009 Sep.

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 cm(2)) 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.

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Figures

Fig. 1
Fig. 1
The photograph shows the uncemented straight titanium CLS® Spotorno® femoral component (Zimmer Inc) with proximal fins and a grit-blasted surface finish.
Fig. 2
Fig. 2
A flowchart illustrates the patient status at the latest visit 15 to 20 years postoperatively.
Fig. 3
Fig. 3
The survival rate with all revisions of the femoral component as an end point is shown. Survival rates were at 96% at 5 years, 94% at 10 years, 91% at 15 years, and 88% at 17 years. n = number at risk.
Fig. 4
Fig. 4
The survival rate with revision for aseptic loosening of the femoral component as an end point is shown. Survival rates were at 99% at 5 years, 97% at 10 years, 95% at 15 years, and 94% at 17 years. n = number at risk.
See this image and copyright information in PMC

References

    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. doi: 10.1302/0301-620X.85B2.13216. - DOI - PubMed
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