Abstract
PurposeThe aim of this retrospective observational study of one cohort was to evaluate the long-term outcome in patients younger than 60 years after total hip arthroplasty using a straight uncemented stem and an uncemented threaded cup.MethodsBetween 1986 and 1987, 75 hips of 75 patients (mean age, 53.35 ± 6.17 years) were consecutively implanted with an Alloclassic Zweymüller/Alloclassic SL stem and an Alloclassic CSF cup. Forty-four patients had died over the last 30 years. The remaining 31 patients (mean age, 82.9 ± 6.4 years) were reinvited for follow-up examinations. Clinical and radiographic evaluations were carried out.ResultsAt a mean follow-up of 29.5 (28.8–30.2), 4 patients (5.3%) were lost to follow-up.For the endpoint aseptic loosening (defined as the removal of stem or the cup for 2 cases), the overall survival rate is 97.3%. For the endpoint revision for any reason (22 patients), the survival rate is 70.6%. Eleven patients needed an exchange of head and liner, caused by wear. The average time from implantation until change of head and liner was 21.44 years (SD 5.92). Other reasons for revision surgery were septic loosening (3 cases), aseptic loosening of stem and cup (1 case), aseptic loosening of stem (1 case), periprosthetic calcification (2 cases), implant fracture (1 case), periprosthetic fracture (1 case), intraoperative fissure of stem (1 case), and total wear of liner including cup (1 case).ConclusionThe combination of a straight stem (Alloclassic) and a screw cup (CSF) shows excellent results in young patients under the age of 60 at ultra-long-term follow-up at 30 years. Revisions due to wear of the polyethylene liner are more likely than in the older patients.
Highlights
Various studies and registry data deal with short- and midterm results of the cementless implanted Alloclassic Zweymüller hochgezogen, the Alloclassic SL, and the Alloclassic Conical self-tapping fixation (CSF) screw cup system [1,2,3]
Available data does not show satisfying evidence regarding the benchmark of 90% survivorship after 10 years, set by the National Institute of Clinical Excellence, NICE [14]
Between 1986 and 1987 seventy-five hips in 75 consecutive patients 60 years of age or younger at time of surgery were treated in our institution with a cementless total hip arthroplasty system
Summary
Various studies and registry data deal with short- and midterm results of the cementless implanted Alloclassic Zweymüller hochgezogen, the Alloclassic SL, and the Alloclassic CSF screw cup system [1,2,3]. These implants have excellent results in older patients [3]. Other wellestablished stem systems are reported to have excellent long-term results such as Bicontact [5, 6], Taperloc [7], Corail [8, 9], and CLS [10,11,12] as well as threaded cups such as T-TAP ST [13]. Only straight stems have an ODEP 13A* rating (http:// www.odep.org.uk/products.aspx [15])
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