The outcome of the cementless tapered SL-Plus stem: an analysis of arthroplasty register data

Abstract

Purpose The aim of this study is to evaluate the outcome of the cementless SL-Plus stem in worldwide arthroplasty register datasets. Methods A structured analysis was conducted the registered data about the SL-Plus stem manufactured by Smith&Nephew including published data from Australia as well as previously unpublished datasets from the Registers of Lombardia, Italy and Valdoltra, Slovenia. A total of 75% of the data analysed had not been published so far. The primary outcome measure was the revision rate, calculated in revisions per 100 observed component years. We evaluated a total of 10,684 primary and 122 revision surgeries with an average follow-up period of four years. Results All datasets showed good and reproducible results for treatment with the SL-Plus stem. An average of 0.31 revisions per 100 observed component years had been reported, which is considerably below the worldwide average (1.29) found for total hip arthroplasty independent of the product. The results of a large centre did not essentially deviate from the revision rates in Lombardia, where the numbers of cases per department are relatively low on average.Conclusions There were no indications for product defects or relevant errors in application. The SL-Plus stem can be considered a high-quality product that ensures good results also in the hands of less experienced surgeons. Data from even young registers can substantially contribute to the assessment of implants, even with the short follow-up periods. These datasets particularly allow for valid assessment of safety issues and can therefore make an essential contribution to the solution of problems of current relevance.

Application and surgical technique of total knee arthroplasties: a systematic comparative analysis using worldwide registers

“…These variations may be explained by several factors including patient demographics (prevalence of joint disease) and national conditions such as healthcare systems (insurance status), availability of surgeons and medical facilities and surgeon-dependent factors such as definition of indications, education, tradition and experience [10].…”

“…National joint arthroplasty registries facilitate an exchange of experiences concerning new materials and surgical methods, which is beneficial for the evaluation of efficacy and detection of failures and disadvantages as early as possible. Furthermore, national registers play an important role in the comparative analysis of implant performance, the detection of revision rates following total joint arthroplasty, and identification of patients for the purpose of follow-ups and recalls [5][6][7][8][9][10]. This allows a continuous, evidencebased adaptation of implant-choice and surgical technique to achieve improved results.…”

Fretting and Corrosion Between a Metal Shell and Metal Liner May Explain the High Rate of Failure of R3 Modular Metal-on-Metal Hips

“…This result put the R3 system in the 'at risk range', albeit at the lower end. Labek et al, analysed datasets from three different countries regarding the outcome of the cementless tapered SL stem [8]. This study showed that the combination with the R3 acetabular system showed a higher revision rate when compared with another more frequently used cup.…”

The incidence of implant fractures after total hip arthroplasty

“…Calculations based on worldwide register reports concerning reasons for revisions in relation to the patient's lifetime show that, despite all achievements of modern joint arthroplasty, a considerable proportion of patients must still reckon with revision surgery [4,[53][54][55][56]. In detail, one out of 13 patients has to be revised due to aseptic implant loosening after THA implantation and one out of 93 patients in consequence of a septic complication.…”