Related Experiment Video
Updated: May 13, 2025
Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
Published on: February 27, 2018
Excellent long-term outcomes with an anatomic cementless stem (SPS Evolution) designed using a CT-scan database and
Elhadi Sariali1, Sena Boukhelifa1
1Hôpitaux Universitaires La Pitié Salpêtrière-Charles-Foix, AP-HP, F-75013, Paris, France.
Background:
Recently, improved hip reconstruction accuracy after total hip arthroplasty (THA) was reported with a specific anatomic stem featuring helicoidal torsion and a double sagittal curvature (SPS Evolution™), compared to the standard double-tapered straight stem, which remains the most widely used design globally. However, no studies have analyzed the ten-year outcomes of THA using this stem. The objective of this study was to assess the survivorship of SPS Evolution™ at ten-year follow-up.
Hypothesis:
The use of the modified SPS Evolution™ design provides excellent long-term fixation, a low risk of stress shielding and thigh pain, and a reduced dislocation rate.
Material And Methods:
A prospective cohort study included 134 consecutive patients who underwent surgery between December 2011 and December 2013. An anatomic stem (SPS Evolution™) with exclusive proximal surface treatment, a cementless acetabular component, and a Delta ceramic-ceramic bearing couple were used in all patients. In total, 102 patients (118 hips), with a mean age of 60 ± 11 years (range, 32-83 years), were evaluated after an average follow-up of 10.6 ± 0.6 years (range, 10-12 years), using the Harris Hip Score (HHS) and the Oxford Hip Score (OHS) self-assessment questionnaires. The fixation and stability of the femoral stem were assessed using the Engh and ARA scores.
Results:
An early femoral revision was performed on a 69-year-old woman following a post-traumatic femoral fracture. With aseptic loosening as the endpoint, the survival rate was 100% in 118 hips (95% CI, 96.7-100%) at 10 years. Excellent clinical outcomes were observed, with a mean HHS score of 97.6 ± 6.2 (range, 69-100) and an OHS score of 44.9 ± 5.2 (range, 23-48). All stems were found to be stable and well-osseointegrated.
Discussion:
The SPS Evolution™ stem demonstrated an excellent ten-year survival rate. In addition to precise hip reconstruction, it provided excellent clinical and radiological outcomes, indicating that the SPS Evolution™ is a reliable and "conservative" implant.
Level Of Evidence:
IV, prospective cohort study without control group.
