High medium-term survivorship and durability of Zweymüller-Plus total hip arthroplasty
- 380 Downloads
Background and purpose
The Zweymüller-Plus system (SL-Plus stem, Bicon-Plus threaded cup) for primary total hip arthroplasty (THA) was introduced in 1993, as a successor of the Alloclassic THA with a few modifications in the conical stem shape and a new biconical threaded cup with a spherical shape. The medium-term performance of this system is not well established. To better understand the potential impact these design changes have had on (1) survivorship, (2) implant stability and (3) periprosthetic osteolysis, we studied patients who underwent THA using the SL-Plus stem and Bicon-Plus.
We retrospectively reviewed the cases of 148 patients (153 hips) who underwent Zweymüller-Plus primary THA after an average of 11 years.
With revision for aseptic failure of biological fixation as the endpoint, survivorship was 98% for the stem and 100% for the cup. Focal osteolysis was observed in 6.6% of cups and 29% of stems. Four hips (2.6%) were revised because of aseptic failure of the biologic fixation and three hips (1.95%) for deep infection. As much as 146 stems and 149 cups were evaluated to be stable.
Zweymüller-Plus THA resulted in high survivorship and durability at 11 years, although the rate of osteolysis around the stem indicated polyethylene wear.
KeywordsCeramic-on-polyethylene total hip arthroplasty Zweymuller-Plus Aseptic loosening Polyethylene wear Periprosthetic osteolysis Implant survivorship
We thank Dr Iliopoulos Panagiotis (senior musculoskeletal radiologist) for his valuable contribution in the evaluation of the pre- and postoperative radiographs of the patients. Additionally, we appreciate the work provided in statistical analysis by Peter Fennema and Georgios Korovesis.
Conflict of interest
Each author certifies that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.
- 16.Grübl A, Chiari C, Giurea A, Gruber M, Kaider A, Marker M, Zehetgruber H, Gottsauner-Wolf F (2006) Cementless total hip arthroplasty with the rectangular titanium Zweymuller stem. A concise follow-up, at a minimum of fifteen years, of a previous report. J Bone Joint Surg Am 88:2210PubMedCrossRefGoogle Scholar
- 20.Hellman EJ, Capello WN, Feinberg JR (1999) Omnifit cementless total hip arthroplasty. A 10-year average followup. Clin Orthop 364:161Google Scholar
- 27.Köster G, Leib S, Willert H-G (1998) Noncemented hip replacement using a conical screw-in cup and a straight press-fit stem. A six to eight-year clinical and radiological follow-up study. Hip Int 8:208Google Scholar
- 34.Scheier H, Sandel J (1976) Wear affecting the plastic cup in metal-plastic endoprostheses. In: Gschwend N, Debrunner HU (eds) Total hip prosthesis. H Huber, Bern, p 186Google Scholar
- 46.Zweymuller K, Deckner A, Kupferschmidt W, Steindl M (1998) Further development of the cementless conical threaded cup. In: Zweymüller K (ed) The Zweymüller total hip prosthesis—15 years experience. Hogrefe & Huber Publishers, Bern, pp 65–101Google Scholar
- 47.Zweymuller K, Deckner A, Steindl M (1998) The SL-Plus and the SLR-Plus stem: concepts and early results. In: Zweymüller K (ed) The Zweymüller total hip prosthesis—15 years experience. Hogrefe & Huber Publishers, Bern, pp 135–163Google Scholar