Cementless Spotorno tapered titanium stems

We evaluated the clinical and radiographic results of the first consecutive 154 implantations of a cementless, double-tapered straight femoral stem (cementless Spotorno (CLS), Sulzer Orthopedics) in 141 patients under the age of 55 (mean 47 (13–55)) years. After a mean follow-up of 12 (10–15) years, 11 patients (11 hips) had died and 7 (7 hips) could not be located. 5 patients (5 hips) underwent femoral revision—1 for infection, 1 for periprosthetic fracture and 3 for aseptic loosening of the stem. The overall survival rate of the stem was 97% at 12 years (95% confidence limits, 93%–100%), and survival with femoral revision for aseptic loosening as an end point 98 (95–100)%. The survival rate of the acetabular components was 78 (71–85) % after 12 years. The median Harris hip score at follow-up was 84 points. None of the patients had thigh pain. Radiolucent lines in Gruen regions 1 and 7 were present in 21 hips (17%). 2 hips had radiolucent lines in regions 2–6 on anteroposterior (AP) radiographs. No femoral osteolysis was detected.

The mid- to long-term survival with this type of femoral component is excellent and compares favorably with cemented stems in this age group. However, the high rate of cup loosening and the low Harris hip scores are a concern in this subgroup of young patients.