TOTAL HIP ATHROPLASTY WITH UNCEMENTED CLS SPOTORNO STEM FOR DYSPLASTIC OR CONGENITALLY DISLOCATED HIPS IN ADULTS: A LONG-TERM FOLLOW UP STUDY

Abstract

Introduction: The treatment of “congenital hip disease” by total hip arthroplasty is now well established, but the indications for this type of surgery, the preoperative planning, the selection of the stem and the technique to be followed are still open to debate.

Aim of the study: The purpose of this study is to analyse the long-term follow up after use of the cementless-system (CLS) femoral component designed by Spotorno in dysplastic or congenitally dislocated hips.

Material and Methods: Our study includes 70 hips in 59 patients, 49 females and 10 males, 36 left hips and 34 right hips that treated with total hip arthroplasty from 1987 to 2000. The mean age of the patients was 48.5 years (range 34–74 years). Forty-one hips were congenitally dislocated and twenty-nine were severe dysplastic. Preoperative planning with CT and CAD-CAE system were used for selection of the stem. 11 patients had bilateral total hip arthroplasties with Spotorno CLS stem. Many different cups were used.

Results: The mean follow up was 8.1 years (range 2–14 years). No patients were lost during the follow-up period. Patients were evaluated clinically with Merle d’ Aubigne and Postel hip score. There was a significant postoperative clinical improvement of the mean pain score by 3.7 points, of walking ability by 2.2 points and of motion by 2, 6 points. Thigh pain was not reported. There were no deep infections or mechanical loosening that required revision of the femoral component.

Conclusions: Although, the femoral component Spotorno CLS is used to every kind of hip diseases, had excellent long-term clinical results in adults, with dysplasia or congenital hip dislocation. Spotorno CLS uncemented femoral component represents an attractive option for adults with “congenital hip disease”.