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Orthopaedic Proceedings
Vol. 90-B, Issue SUPP_II | Pages 287 - 287
1 Jul 2008
MESSERLI G SADRI H SCHOLLER J SONNEY F PETER R HOFFMEYER P
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Purpose of the study: This was an analysis of long-term outcome of 260 consecutive total hip arthroplasty (THA) procedures performed with a press-fit CLS-Spotorno cup. This easy-to-position cup preserves bone stock if revision should be needed.

Material and methods: From January 1990 to December 1994, 260 THA were implanted with a CLS-Spotorno cup in 221 patients. The clinical and radiological outcome was assessed with minimal ten years follow-up. Mean age at operation was 63 years (range 26–82 years). Sixty eight patients (68 hips) died before ten years follow-up. Five patients (five hips) could not be transported for review and four patients (four hips) were lost to follow-up. This study thus concerned 183 Spotorno cups (70.3%) in 144 patients (65.1%) who were reviewed clinically at 120–166 months follow-up. One hundred twenty-five patients agreed to undergo a radiological work-up. X-rays were analyzed by several independent operators. Two hundred sixty prostheses were implanted by two senior surgeons using the transgluteal approach. The Harris score and the De-Lee-Charnley radiological assessment as well as the Kaplan-Meier survival curve were determined.

Results: Seven cups were revised (3.8%): three because of aseptic loosening, two during stem revision because of polyethylene wear, and two for recurrent dislocation. Radiographically, four cups (2.2%) had migrated and there was a lucent line adjacent to the cup in at least one of the three De-Lee-Charnley zones for 23 cups (12.5%). There were no cup wing fractures. The mean Harris score for 144 patients (183 hips) was 90 points (range 37–100) at last follow-up. Outcome was considered excellent for 123 hips (67%), good for 34 (18.5%), fair for 20 and mediocre for five. The Kaplan-Meier 10-year survival with revision as the end point was 99% (CI: 94.8–99.8%).

Discussion: The 10-year survival of CLS-Spotorno cups is excellent with a low rate of revision. These results can be tempered by the radiological findings, although the lucent lines were already visible on the 12-month x-rays with no visible progression.

Conclusion: This cup provides excellent long-term results with a survival curve comparable to other press-fit cups. It is easy to position and revise.


Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_III | Pages 291 - 291
1 Mar 2004
Messerli G Saudan M Riand N Pru•s-Latour V Fritschy D
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Aims: Evaluation of unicompartmental knee arthroplasty (UKA) as an alternative to total knee replacement. Methods: 66 patients (76 knees) underwent UKA with the Allegretto prosthesis. The indication was age greater than 60 years, single compartment arthrosis, normal functioning anterior cruciate ligament, and varus/valgus deformity < 20û. Etiology was primary or secondary osteoarthrosis, the latter secondary to avascular necrosis. Mean age at operation was 70 years (range, 55 to 90 years). Patients were evaluated using the Hospital for Special Surgery (HSS) rating score. Eight patients (8 knees), with less than 12 month follow-up were excluded. 58 patients (68 knees) were available at þnal review with a mean follow-up of 65 months (range, 12 to 120 months). Results: The average HSS score was 87.7 (range, 55 to 99). There were 53 (78%) excellent, 12 (17.5%) good, 2 fair, and 1 poor result. 52 patients (76%) had a BMI > 25. There was no signiþcant difference in HSS score between these patients and those with BMI < 25. Six knees (8.8%) were revised, 4 in obese patients (BMI > 25), and 2 in the same patient (bilateral) with a BMI of 32.9 (100kg). All 6 patients had a satisfactory outcome after total knee arthroplasty. There were no infections. Conclusions: UKA for uni-compartmental knee osteoarthrosis in properly selected patients produces satisfactory results. Moderate weight obesity is not an exclusion criteria.