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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2013 December;64(6):589-95
PLS cementless stem for total hip arthroplasty. Early results
Bistolfi A. 1, Ravera L. 2, Giordano A. 2, Cimino A. 2, Collo G. 1, Massazza G. 1 ✉
1 Second Orthopedic Unit, Department of Orthopedics and Traumatology CTO Hospital, Turin, Italy;
2 University of Turin, Turin, Italy
Aim: The finned Spotorno stem has proven to be one of the most successful cementless prosthetic stems, since it was launched on the market in 1985. In 2003 Lima-Lto (Lima, San Daniele del Friuli, Udine, Italy) gave a new vision to the design creating the PLS stem, seeking the best proximal fixation without bone-implant contact in the distal portion of the stem to prevent stress-shielding. Aim of this study was the evaluation of the first results of the use of this new stem.
Methods: This was a prospective case series of 331 THA performed from January 2007 to December 2011 in 310 patients: patients were evaluated preoperatively, then postoperatively at 1 month, 3 months, 6 months and 1 year after surgery, and then yearly thereafter, and HHS score was filled in for monitoring their evolution. For radiographic post-operative evaluation, standard pelvis antero-posterior and lateral radiographs of the hip were taken.
Results: Average follow-up was approximately 3.1 years (min 1 years - max 5 years). All HHS score items had a statistically significant improvement from preoperative (43.2±8.33 SD) to postoperative (91.29±5.97 SD). 2 cases (0.6%) of isolated aseptic loosening of the acetabular component was observed in two of the hips. To date, none of the femoral stems have been revised. Taking failure with hip arthroplasty revision at the endpoint, the cumulative average survival rate at 3 years was 99.3±0.2% SD.
Conclusion: The stem showed excellent clinical results, reduced rate of complications and had no failure at the short period. Its use can therefore be recommended, while further and continuous follow-up is necessary to assess the long-term outcome.