Long-term results with the cementless CLS stem

Abstract

This retrospective study reviews 298 sequential cementless CLS Spotorno stems, which achieved their primary fixation and bony in- or ongrowth predominantly in the metaphyseal region. The minimum follow-up was 10 years and the average follow-up 11.7 years (range 10-14). The mean age at surgery was 55.2 years (range 32.2-68.9). Of the patients, 76.2% (227 stems) were followed up: 172 patients (57.7%) underwent clinical and radiological examination and 52 patients (55 stems, 18.5%) were interviewed by telephone. Of 298 stems, 13 (4.4%) had been replaced in the mean time, only 6 stems (2.0%) because of an aseptic loosening. The evaluation included both clinical (Merle d'Aubigne and Harris hip score) and radiographic parameters (plain X-rays). The mean Merle d'Aubigne score was 16.7 points, and the mean Harris hip score was 94.3 points. Radiolucent lines were detected in 33.7%; 5.8% showed enlargement within the last 3 years. Focal osteolyses were present in 30.8% of patients; 2.9% had progressed within the last 3 years. At follow-up, one patient presented with new clinical and radiological evidence of aseptic stem loosening. The current study showed an aseptic loosening of the CLS stem in 2.3%, a good osseointegration and good functional score results in more than 90%. The primary fixation and bony in- or ongrowth predominantly in the metaphyseal region seems to achieve good clinical results. Wear is the main reason for the osteolytic changes. Frequent clinical and radiological follow-up is important to detect bone reactions and loosening of the stem.

Cementless Spotorno tapered titanium stems

“…Similar HHS (mean 88 points) have been reported with this stem type and threaded sockets (Schramm et al 2000). In combination with a press-fit acetabular cup higher scores (mean 94 points) have been found (Siebold et al 2001), which would suggest that acetabular failure is partly responsible for the lower scores.…”

Continuous bone loss around a tapered uncemented femoral stem: A long-term evaluation with DEXA

“…A more favorable stressshielding effect is generally observed in designs with a more slender geometry without coating (i.e. press-fit stems), but the frequency of proximal radiolucencies is high, and is progressive over many years (Donnelly et al 1997, Siebold et al 2001, Pospischill et al 2005, Vervest et al 2005). This sign is a known predictor of aseptic loosen-ing and revision (Malchau et al 1997, Khalily andWhiteside 1998).…”

Pooled outcome of total hip arthroplasty with the CementLess Spotorno (CLS) system: a comparative analysis of clinical studies and worldwide arthroplasty register data

“…The pooled relative revision rates of the CementLess Spotorno (CLS) system (Zimmer, Warsaw, IN) in total hip arthroplasty (THA) of one inventor study [6], 19 independent studies [5,[7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] and worldwide arthroplasty registers [25] are illustrated in Fig. 2.…”

“…Twenty publications were identified as meeting the inclusion criteria and further analysed in full text [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24]. We compared clinical follow-up studies with datasets from arthroplasty registers and distinguished between results from inventor studies, independent studies (not from the inventor) and register datasets.…”

“…Since the Merle d'Aubigné and Harris hip score were mentioned in a considerable number of articles, these scores were chosen for evaluation [5][6][7][8][10][11][12][13][14][15][16][17][18][19][20][21][22][23].…”