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Related Experiment Videos

Hip arthroplasty using the cementless CLS stem. A 2--4-year experience

R P Robinson1, T P Lovell, T M Green

  • 1Adult Hip and Knee Reconstruction Service, Virginia Mason Medical Center, Seattle, Washington.

The Journal of Arthroplasty
|April 1, 1994
PubMed
Summary

The Cementless Spotorno (CLS) stem demonstrated excellent clinical outcomes in hip arthroplasty patients, with no revisions needed. However, some cases showed proximal stress shielding, indicating a need for design considerations.

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Area of Science:

  • Orthopedic surgery
  • Biomedical engineering
  • Radiology

Background:

  • Total hip arthroplasty (THA) is a common procedure for hip joint conditions.
  • Cementless femoral stems offer potential advantages in younger, active patients.
  • The Cementless Spotorno (CLS) stem is designed for proximal fixation without distal canal fill.

Purpose of the Study:

  • To evaluate the clinical and radiographic outcomes of the Cementless Spotorno (CLS) femoral stem in hip arthroplasty.
  • To assess the implant's performance in a cohort of younger, heavier patients.
  • To investigate potential complications such as thigh pain, limp, and stress shielding.

Main Methods:

  • A retrospective review of 51 CLS stems implanted in 43 patients.
  • Clinical assessment using the Harris hip score at a mean follow-up of 31 months.

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  • Radiographic evaluation for bone apposition, proximal bone density changes, and stress shielding.

    • Main Results:

    • Excellent or good clinical ratings were achieved in 96% of hips.
    • No stem revision was required.
    • Radiographic findings included bone apposition at the stem tip (53%) and proximal stress shielding (55%), suggesting altered load transfer.
    • A high dislocation rate (unspecified percentage) was noted, attributed to biomechanical factors.

    Conclusions:

    • The CLS stem provides good short-term clinical results and avoids revision in a challenging patient group.
    • Radiographic changes suggest a shift from initial proximal to some distal load transfer, leading to proximal stress shielding.
    • Further investigation into design modifications and patient selection is warranted to mitigate stress shielding and high dislocation rates.