Clinical and radiological outcomes of the SL-Plus stem with a minimum 10-year follow-up: A retrospective study.

L Palacios-Díaz, R Fernández-Fernández, A Losa Sánchez, A Cruz-Pardos
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Abstract

Purpose: The SL-Plus cementless stem was introduced in 1993 as an evolution of the Alloclassic® stem with some modifications. The aim of this study was to analyse if these modifications have any influence in clinical and radiological outcomes at minimum 10-year follow-up.

Methods: Sixty-eight consecutive implants (64 patients) were retrospective evaluated. The mean duration of clinical and radiographic follow-up was 12.2 years. There were 41 female and 23 male patients with a median age of 73.5 years. All complications and reinterventions were collected. Functional outcomes were assessed using the modified Harris Hip Score (mHHS). Radiographs were evaluated immediately after the operation, after a minimum 2-year follow-up and by the end of follow-up (time A, B and C, respectively).

Results: Two stems were revised, one due to periprosthetic fracture and one due to aseptic loosening with a cumulative probability of not having a stem revision for any reason of 97.2% at 12.2 years. Mean mHHS was 76.7 points at the latest follow-up. Significant differences were found in distal migration (time A: 5.9mm±6.7; B: 6.9mm±7.1 and C: 8.2mm±6.3; P=.000) and varus angulation (time A: 0.0°±2: B: 0.0°±2 and C: 1.0°±3; P<.001), although these stems showed radiographic signs of osseointegration. Thirty-three hips (48.5%) showed any radiolucent line around the stem, most of them located the proximal femur (Gruen 1 and 7). Multivariate regression analysis showed lower mHHS scores in older patients (P=.004) and female (P=.00).

Conclusions: The modifications of the SL-Plus stem influence the long-term outcome of the implant regarding radiological results, particularly in progressive varus angulation and distal migration. However, our study has not been able to demonstrate any clinical repercussions: functional scores and survival free of all cause revision were favorable and comparable to previous reports.

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至少随访 10 年的 SL-Plus 支架的临床和放射学效果:一项回顾性研究。
目的:SL-Plus无骨水泥柄于1993年推出,是Alloclassic柄的改进版,并进行了一些修改。本研究的目的是分析这些改良是否会影响至少10年随访的临床和放射学结果:方法:对68例连续种植体(64名患者)进行了回顾性评估。临床和放射学随访的平均时间为 12.2 年。其中女性患者 41 人,男性患者 23 人,中位年龄为 73.5 岁。所有并发症和再干预情况均已收集。使用改良哈里斯髋关节评分(mHHS)评估功能结果。术后立即、至少两年随访后和随访结束时(分别为时间A、B和C)对X光片进行评估:12.2年后,未因任何原因进行骨干翻修的累计概率为97.2%。最近一次随访时,mHHS的平均值为76.7分。远端移位(A时间:5.9mm±6.7,B时间:6.9mm±7.1,C时间:8.2mm±6.3;p=0.000)和屈曲角度(A时间:0.0°±2,B时间:0.0°±2,C时间:1.0°±3;p结论:SL-Plus骨干的改良影响了植入物的长期放射学结果,尤其是在渐进性屈曲成角和远端移位方面。然而,我们的研究并未显示出任何临床影响:功能评分和无各种原因翻修的存活率均良好,与之前的报告相当:证据等级:治疗四级(病例系列)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
1.10
自引率
0.00%
发文量
156
审稿时长
51 weeks
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