Follow-up (6-9 years) results of the uncemented CLS Spotorno stem.

The aseptic loosening rate in uncemented hip endoprostheses, especially the stem, is one of the most discussed problems among hip surgeons within the last few years. The first generation of uncemented stems had an essentially higher loosening rate compared with cemented stems. Although there are many reasons for this disappointing fact, the type of primary fixation and polyethylene wear are the two main ones. We reviewed 145 sequential uncemented CLS Spotorno stems, which achieved their primary fixation and bony in- or ongrowth predominantly in the metaphyseal region. The mean age of the patients was 54.9 years (range 37-76 years), and average follow-up was 7.8 years. The evaluation included both clinical (Merle d'Aubigne and Harris Hip Score) and radiographic parameters (plain X-rays). The medium-term follow-up showed a survival rate of 96.7% and good functional score results in more than 90%. Special attention was paid to the so-called thigh pain phenomenon which, despite current views, was found to be unexpectedly low (only one case). Although these results are encouraging, a further long-term follow-up of more than 10 years will have to show whether or not comparable results to cemented stems can be realised.