Aldinger Peter R, Jung Alexander W, Breusch Steffen J, Ewerbeck Volker, Parsch Dominik
Stiftung Orthopädische Universitätsklinik Heidelberg, Schlierbacher Landstrasse 200a, 69118, Heidelberg, Germany.
Clin Orthop Relat Res. 2009 Sep;467(9):2297-304. doi: 10.1007/s11999-009-0906-7. Epub 2009 Jun 6.
High survival rates have been reported for the uncemented CLS Spotorno 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.
据报道，非骨水泥型CLS Spotorno股骨柄的10年生存率很高。为了确认更长随访期的生存率，我们报告了使用该股骨柄的257例髋关节的至少15年随访结果（平均17年；范围15 - 20年）。我们回顾性评估了1985年至1989年间接受手术的所有326例患者（354例全髋关节置换术）的临床和影像学结果。患者平均年龄57岁，使用非骨水泥喷砂处理的锥形钛股骨柄。86例患者（89髋）死亡，8例患者（8髋）失访，剩余240例患者（257髋）进行评估。35髋进行了股骨部件翻修：8例因感染，9例因假体周围骨折，1例因创伤性松动，17例因无菌性松动。股骨柄17年生存率为88%（95%置信区间，84% - 92%），以无菌性松动进行股骨翻修为终点的生存率为94%（95%置信区间，91% - 97%）。随访时Harris髋关节评分中位数为80分。未报告大腿疼痛。28髋（15%）在近端Gruen区（1区或/和7区）发现小的骨溶解病变（< 1 cm²）。未发现股骨远端骨溶解。在第二个十年中，这种类型的股骨部件长期生存率仍然很高。
