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Long-term survival of the cemented Müller CDH stem: a minimum follow-up of 10 years

Yves Salentiny1, Lukas Zwicky1, Peter E Ochsner1

  • 1Clinic for Orthopedics and Trauma Surgery, Kantonsspital Baselland, Rheinstrasse 26, 4410, Liestal, Switzerland.

Archives of Orthopaedic and Trauma Surgery
|July 27, 2018
PubMed

Insights

The cemented Müller CDH stem shows long-term survival comparable to other hip implants. However, titanium stems with low-viscosity cement significantly increase the risk of aseptic loosening and should be avoided.

Area of Science:

  • Orthopedic surgery
  • Biomaterials science
  • Arthroplasty research

Background:

  • Total hip arthroplasty (THA) for hip dysplasia is complex, often needing specialized stems.
  • Müller straight stems offer good long-term outcomes, but data on cemented Müller CDH stems are limited.

Purpose of the Study:

  • To evaluate the long-term survival of cemented Müller CDH stems.
  • To identify risk factors for aseptic loosening.
  • To assess the radiological outcomes of these implants.

Main Methods:

  • Analysis of 95 cemented Müller CDH stems (stainless steel, CoCr, Ti) implanted between 1985-2005.
  • Prospective clinical and radiological follow-up.
  • Competing risk and multivariate regression models for survival and risk factor analysis.

Main Results:

  • 15-year cumulative revision risk for aseptic loosening was 12.5%.
  • Titanium (Ti) stems had a 24.5% revision risk, significantly higher than stainless steel (2.7%) and CoCr (12.9%).
  • Risk factors for aseptic loosening included Ti stems with low-viscosity cement (HR 10.2) and axis deviation >3° (HR 3.8).

Conclusions:

  • Cemented Müller CDH stem survival is comparable to other straight stems and uncemented options.
  • Titanium Müller CDH stems demonstrate an elevated risk of aseptic loosening, similar to the original Ti Müller straight stem.
  • The use of titanium Müller CDH stems is not recommended.
Abstract

Keywords:
Aseptic looseningCDHCemented stemHip dysplasiaRisk factorsTotal hip arthroplasty

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