LONG-TERM (20 TO 25 YEAR) RESULTS OF AN UNCEMENTED TAPERED FEMORAL STEM IN PRIMARY TOTAL HIP ARTHROPLASTY

Abstract

Introduction: High survival rates have been reported for the uncemented CLS Spotorno stem up to 20 years. To confirm survival at longer follow-up we report the minimum 20-year (mean, 22 years; range, 20–25 years) results using this device.

Methods: We retrospectively evaluated the clinical and radiographic results of a consecutive series of 354 total hip arthroplasties using an uncemented grit-blasted, tapered femoral stem (CLS Spotorno) in 326 patients. Mean time of follow-up evaluation was 22 years (range, 20–25 years), mean age at surgery was 57 years (range, 13–81 years). Clinical results were evaluated using the Harris Hip Score. Kaplan-Meier survivorship analysis was used to determine long term outcomes for different end points.

Results: At final follow-up, 126 patients (136 hips) had died, and 7 patients (8 hips) were lost to follow-up. Forty-one hips (12%) in 38 patients underwent femoral revision – 10 (3%) for infection, 12 (3%) for late periprosthetic fracture, and 19 (5%) for aseptic loosening of the stem. Kaplan-Meier analysis, with revision of the femoral component for any reason as the end point, revealed that the survival rate at 22 years was 86% (95%-confidence limits, 82%–90%). The survival rate with femoral revision for aseptic loosening as the end point was 93% at 22 years (95%-confidence limits, 90% – 96%).

Discussion and Conclusion: The long-term results with this type of uncemented femoral component are encouraging and compare to the best reported series in primary cemented total hip arthroplasty. Besides aseptic loosening, periprosthetic femoral fracture is an important mode of failure in the long term following uncemented THA.