Survival of the Cementless SpotornoA® Stem in the Second Decade

High survival rates have been reported for the uncemented CLSA (R) Spotorno(A (R)) stem up to 10 years. To confirm survival at longer followup we report the minimum 15-year (mean, 17 years; range, 15-20 years) for 257 hips using this stem. We retrospectively evaluated the clinical and radiographic results of all 326 patients (354 THAs) operated between 1985 and 1989. The patients had a mean age of 57 years using an uncemented grit-blasted, tapered titanium femoral stem. Eighty-six patients (89 hips) died and eight patients (eight hips) were lost to followup, leaving 240 patients (257 hips) for evaluation. The femoral component was revised in 35 hips: eight for infection, nine for periprosthetic fracture, one for traumatic loosening, and 17 for aseptic loosening. Survival of the stem was 88% at 17 years (95% confidence interval, 84%-92%), and survival with femoral revision for aseptic loosening as an end point was 94% (95% confidence interval, 91%-97%). The median Harris hip score at followup was 80 points. No thigh pain was reported. Small osteolytic lesions (< 1 cm(2)) were found in the proximal Gruen zones (1 or/and 7) in 28 hips (15%). No distal femoral osteolysis was found. The long-term survival with this type of femoral component remains high in the second decade. Level of Evidence: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.