The CLS Stem

Spotorno, L.; Grappiolo, Guido; Mumenthaler, A

doi:10.1007/978-3-642-79306-6_20

Cited by 9 publications

(5 citation statements)

References 26 publications

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“…Cementless total hip arthroplasty (THA) was originally designed for middle-aged patients with normal bone quality (Spotorno et al. 1995 ). However, undiagnosed osteoporosis, which is not uncommon in postmenopausal women with hip osteoarthritis (Glowacki et al.…”

mentioning

confidence: 99%

Increased migration of uncemented acetabular cups in female total hip arthroplasty patients with low systemic bone mineral density

et al. 2015

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Background and purposeLow bone mineral density (BMD) may jeopardize the initial component stability and delay osseointegration of uncemented acetabular cups in total hip arthroplasty (THA). We measured the migration of uncemented cups in women with low or normal BMD.Patients and methodsWe used radiostereometric analysis (RSA) to measure the migration of hydroxyapatite-coated titanium alloy cups with alumina-on-alumina bearings in THA of 34 female patients with a median age of 64 (41–78) years. 10 patients had normal BMD and 24 patients had low systemic BMD (T-score ≤ −1) based on dual-energy X-ray absorptiometry (DXA). Cup migration was followed with RSA for 2 years. Radiographic follow-up was done at a median of 8 (2–10) years.ResultsPatients with normal BMD did not show a statistically significant cup migration after the settling period of 3 months, while patients with low BMD had a continuous proximal migration between 3 and 12 months (p = 0.03). These differences in cup migration persisted at 24 months. Based on the perceived risk of cup revision, 14 of the 24 cases were “at risk” (proximal translation of 0.2 to 1.0 mm) in the low-BMD group and 2 of the10 cases were “at risk” in the normal-BMD group (odds ratio (OR) = 8.0, 95% CI: 1.3–48). The radiographic follow-up showed no radiolucent lines or osteolysis. 2 cups have been revised for fractures of the ceramic bearings, but none for loosening.InterpretationLow BMD contributed to cup migration beyond the settling period of 3 months, but the migrating cups appeared to osseointegrate eventually.

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confidence: 99%

Increased migration of uncemented acetabular cups in female total hip arthroplasty patients with low systemic bone mineral density

et al. 2015

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“…There also is a marketing brochure from the manufacturer for both stems together, including high-quality pictures to illustrate the similarities between both systems (5). Of note, the publication of the design philosophy of the CLS stem by Prof. Spotorno et al also is coauthored by our colleagues (6).…”

mentioning

confidence: 89%

Reply to the Letter to the editor from Grappiolo G et al. to the article ‘The History of the development of the regular straight stem in hip arthroplasty’

Wellauer,

Heuberger,

Gautier

et al. 2024

EFORT Open Reviews

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“…It has a three-dimensional taper and a trapezoidal cross-section, as well as proximal longitudinal ribs to enhance the primary torsional stability, respectively, to provide a large surface area for osseous integration. Rounded edges should prevent stress concentration (106,113,114). The length was chosen in such a way that the stem centered itself within the diaphysis (( 114), making the stem rather long and requiring sufficient exposure for introduction within the axis of the diaphysis.…”

Section: Other Evolutions Of Uncemented Stemsmentioning

confidence: 99%

The history of the development of the regular straight stem in hip arthroplasty

et al. 2023

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Since the middle of the 20th century, total hip arthroplasty has become a very successful treatment for all end-stage diseases of the hip joint. Charnley solved with his low frictional torque arthroplasty the problem of wear and friction with the introduction of a new bearing couple and the reduction of the head size, which set the prerequisite for the further development of stem design. This narrative review presents the major developments of regular straight stems in hip arthroplasty. It does not only provide an overview of the history but also assembles the generally scarce documentation available regarding the rationale of developments and illustrates often-unsuspected links. Charnley's success is based on successfully solving the issue of fixation of the prosthetic components to the bone, using bone cement made of polymethyl-methacrylate. In the field of cemented anchorage of the stem, two principles showing good long-term revision rates emerged over the years: the force-closed and the shape-closed principles. The non-cemented anchorage bases on prosthesis models ensure enough primary stability for osteointegration of the implant to occur. For bone to grow onto the surface, not only sufficient primary stability is required but also a suitable surface structure together with a biocompatible prosthetic material is also necessary.

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The CLS Stem

Cited by 9 publications

References 26 publications

Increased migration of uncemented acetabular cups in female total hip arthroplasty patients with low systemic bone mineral density

Increased migration of uncemented acetabular cups in female total hip arthroplasty patients with low systemic bone mineral density

Reply to the Letter to the editor from Grappiolo G et al. to the article ‘The History of the development of the regular straight stem in hip arthroplasty’

The history of the development of the regular straight stem in hip arthroplasty

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