Abstract
The grit-blasted cementless Spotorno (CLS) stem, which has excellent survival rates
up to 10 years, is widely used in total hip arthroplasty (THA). We investigated the
survivorships of CLS stems in THA at a minimum follow-up of 10 years and sought to
identify factors that influence outcomes. A total of 227 hips of 191 patients who
underwent cementless THA with a CLS stem were retrospectively reviewed at a mean follow-up
of 12.3 years. All patients were evaluated clinically and radiographically according
to implant type and surgery-related and patient-related factors. Survivorship was
97.2% when femoral revision for any reason was defined as the end point. Femoral revisions
were performed in 3 hips because of periprosthetic fractures. Survivorship for all
hips, using revision for any reason as the end point, was 92.6%. Two metal-on-metal
THAs were revised because of aseptic loosening or osteolysis around the cup. No significant
differences were evident for type of stem, type of bearing surface, stem alignment,
or patient-related factors. However, a canal fill index of 80% or less was found to
affect cortical remodeling, subsidence, and a change in stem position of 5° or more,
which indicates that care must be taken not to undersize stems. In addition, in view
of the revisions performed, bearing surfaces appear to importantly influence THA survivorship.
Keywords
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Article info
Publication history
Published online: April 05, 2012
Accepted:
February 6,
2012
Received:
January 25,
2011
Footnotes
The Conflict of interest statement associated with this article can be found at doi:10.1016/j.arth.2012.02.005.
Identification
Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
