O3166 10-YEAR RESULTS OF CEMENTLESS TOTAL HIP ARTHROPLASTY IN YOUNG PATIENTS USING THE CLS SPOTORNO STEM AND MORSCHER CUP

Abstract

Aim: A ten-year review of uncemented hip arthroplasty using the Spotorno (CLS) stem, Morscher (Mathys) cup and a ceramic head in patients under the age of 60. Method: 113 hips implanted in 104 patients (mean age 50.5: range 19–60) between 1987 and 1995. Mean follow-up: 9.7 years. A postal questionnaire, based on the modiþed Harris Hip Score was followed by clinical and radiographic examination. Results: 3 patients had died and 18 (17%) could not be traced. Complications: sepsis 2%; aseptic loosening 5%; gross polyethylene wear 1%; fractured ceramic head 1%; periprosthetic fracture 1%. Pain was ñabsentñ or ñmildñ in 90%,and ñmoderateñ in 10%. 59.7% had a modiþed Harris Hip Score above 90, 35.8% between 70 and 90, and 4.5% less than 70 (mean 89.4%). According to Enghñs criteria, femoral stems had Ôingrowth conþrmedñ in 94%, suspected in 5% and þbrous encapsulation in 1%. None was predicted as unstable. Osteolysis was absent around 65.8% of stems, conþned to the neck in 14.8%, present proximally in 17.1% and distally in 2.3%. According to ARA criteria, acetabular þxation was Ôexcellentñ in 72.1%, Ôfairñ in 12.8% and Ôpoorñ in Osteolysis around the cup was Ôabsentñ or in Ôminimal in 91.8%, Ômoderateñ in 3.5% and Ôsevereñ in 4.7% Conclusions: We observed an association between acetabular polyethylene wear rates and radiographic evidence of osteolysis, which was greater around the rough-blasted stem than the hydroxyapatite-coated cup. Where osteolysis is present, the linear wear rate is consistently greater than 0.1mm/year, which may seem high but is comparable to other currently-used cement-less combinations.