Bazán Paula, Torres Adrián, Gómez-Álvarez Jorge, Villarreal Gregorio, San-Julián Mikel, Lamo-Espinosa José María
University of Navarra, Pamplona, Spain.
Hospital Universitario Dr José Eleuterio Gonzalez, Monterrey, Mexico.
Arch Orthop Trauma Surg. 2025 Jun 23;145(1):353. doi: 10.1007/s00402-025-05966-x.
Total hip arthroplasty (THA) is a highly successful orthopedic intervention, with non-cemented stems like the CLS Spotorno and CBC Mathys being widely used. While these stems share a similar tapered design, they may produce different clinical and radiological outcomes. This study aims to compare clinical outcomes (Merlé-D'Aubigné scale) and radiological results between the CBC (Mathys) stem and the CLS Spotorno stem, specifically evaluating cortical hypertrophy, radiolucency, stem subsidence, and implant survival.
A retrospective 1:1 matched cohort study was conducted, including 344 THA patients (172 with CBC Mathys, 172 with CLS Spotorno) treated between 2010 and 2019. Radiological assessment included cortical hypertrophy, radiolucency, and stem subsidence using MEDICAD software. Clinical outcomes were evaluated via the Merlé-D'Aubigné scale. Stem survival was analyzed using Kaplan-Meier curves.
Baseline demographics were similar in both groups. Cortical hypertrophy occurred in 42.4% of the CBC Mathys group, significantly higher than the 4.6% in the CLS Spotorno group (p = 0.03). Radiolucencies were more frequent in the CBC Mathys group (55.2%) compared to CLS Spotorno (18.6%) (p = 0.03). No significant differences in stem subsidence were observed (p = 0.68). The average time of cortical hypertrophy appearance and radiolucency was 12.97 (SD: 15.51) and 13.48 (SD: 15.57) months, respectively. At final follow-up, four CBC Mathys stems were revised due to aseptic mobilization, resulting in a 97.6% survival rate, compared to 100% in the CLS Spotorno group (p = 0.182).
The CBC Mathys stem exhibited higher incidences of cortical hypertrophy and progressive radiolucency, suggesting biomechanical and tissue response differences compared to the CLS Spotorno stem. These radiological findings correlated with a slightly reduced survival rate for the CBC Mathys stem over six years, are already observable in many cases by the end of the first year, warranting further investigation into long-term clinical outcomes.
全髋关节置换术（THA）是一种非常成功的骨科手术，CLS Spotorno和CBC Mathys等非骨水泥型股骨柄被广泛应用。虽然这些股骨柄具有相似的锥形设计，但它们可能产生不同的临床和影像学结果。本研究旨在比较CBC（Mathys）股骨柄和CLS Spotorno股骨柄的临床结果（Merlé-D'Aubigné评分）和影像学结果，特别评估皮质肥大、透亮线、股骨柄下沉和植入物生存率。
进行了一项回顾性1:1匹配队列研究，纳入2010年至2019年期间接受治疗的344例THA患者（172例使用CBC Mathys股骨柄，172例使用CLS Spotorno股骨柄）。影像学评估包括使用MEDICAD软件评估皮质肥大、透亮线和股骨柄下沉。通过Merlé-D'Aubigné评分评估临床结果。使用Kaplan-Meier曲线分析股骨柄生存率。
两组的基线人口统计学特征相似。CBC Mathys组中42.4%出现皮质肥大，显著高于CLS Spotorno组的4.6%（p = 0.03）。CBC Mathys组的透亮线发生率（55.2%）高于CLS Spotorno组（18.6%）（p = 0.03）。股骨柄下沉未观察到显著差异（p = 0.68）。皮质肥大出现和透亮线出现的平均时间分别为12.97（标准差：15.51）个月和13.48（标准差：15.57）个月。在最终随访时，4例CBC Mathys股骨柄因无菌性松动而翻修，生存率为97.6%，而CLS Spotorno组为100%（p = 0.182）。
CBC Mathys股骨柄的皮质肥大和进行性透亮线发生率较高，表明与CLS Spotorno股骨柄相比存在生物力学和组织反应差异。这些影像学结果与CBC Mathys股骨柄在六年内生存率略有降低相关，在许多情况下在第一年末就已可观察到，需要对长期临床结果进行进一步研究。
