Skip to main content
SpringerLink
Log in

13-Jahres-Ergebnisse der CLS-Spreizpfanne in der primären Hüftendoprothetik

Thirteen-year results for the CLS expansion cup in primary hip arthroplasty

  • Originalien
  • Published:
Der Unfallchirurg Aims and scope Submit manuscript

Zusammenfassung

Hintergrund

Bislang publizierte Untersuchungen zur CLS-Spreizpfanne zeigen gute Ergebnisse, allerdings ist der Untersuchungszeitraum mit im Mittel 5–10 Jahren begrenzt. Das Ziel dieser Studie war eine langfristige Nachuntersuchung der CLS-Pfanne mit >10 Jahren Standzeit.

Material und Methode

Nach durchschnittlich 13 Jahren konnten von 186 Patienten, bei denen eine CLS-Pfanne implantiert wurde, 41 Patienten mit insgesamt 41 CLS-Pfannen nachuntersucht werden. Neben der klinischen und radiologischen Beurteilung erfolgte eine digitale Vermessung aller Röntgenbilder mit Auswertung der Pfannenmigration, Inklinationswinkel, Polyethylenabnutzung, Schaftsinterung und Beurteilung aller Osteolysen.

Ergebnisse

Der durchschnittliche Harris-Hip-Score (HHS) ist von 48 Punkten präoperativ auf 81 Punkte postoperativ gestiegen. Radiologische Lockerungen der CLS-Pfannen konnten nicht nachgewiesen werden. Zwei Pfannen zeigten singuläre Osteolysen, wobei jeweils <50% der einzelnen Zone, entsprechend einer Einteilung nach DeeLee und Charnley, betroffen waren. Direkte Lockerungszeichen anhand zunehmender periazetabulärer Sklerosierungslinien zeigte keine der Pfannen. Änderungen der Migration und des Inklinationswinkel wurden nicht beobachtet. Die Polyethylenabnutzung entsprach 0,1 mm/Jahr. 16 Patienten (39%) zeigten Osteolysen um den Schaft, die als radiologische Lockerung beurteilt wurden.

Schlussfolgerung

Bis zu 13 Jahre nach Implantation zeigt die CLS-Pfanne gute Ergebnisse. Die zeitentsprechende Polyethylenabnutzung und in diesem Fall ausgesprochen hohe Anzahl an Schaftlockerungen haben keine Auswirkung auf die Stabilität der CLS-Spreizpfanne in unserem Patientenkollektiv.

Abstract

Background

Clinical studies of the CLS expansion cup in hybrid hip arthroplasty generally show good results. However, follow-up times are limited to between 5 and 10 years. The aim of our study was to assess the clinical and radiological outcome of the CLS cup after more than 10 years.

Material and method

After a follow-up of 13 years (10–15 years), 41 of 186 patients with a total of 41 CLS cups were available for clinical and radiological evaluation. In addition, a digital analysis of all radiographs was done. This included measurement of the migration, inclination, polyethylene wear, shaft subsidence, and osteolytic lesions.

Results

The average preoperative Harris hip score was 48, which increased to 81 at final follow-up. No acetabular loosening was found. Two cups (5%) showed osteolytic lesions not exceeding 50% of the specific zone according to DeeLee and Charnley and were considered stable. There was no migration or inclination of the cups. The average polyethylene wear corresponded to 0.1 mm/year. Sixteen patients (39%) showed osteolyses around the stem and were considered loose.

Conclusion

The CLS expansion cup provides excellent clinical results after 13 years in hybrid total hip arthroplasty. Time-correlative polyethylene wear and the extremely high rate of stem loosening have no consequences for the cup stability in our patient group. Acetabular osteolysis is rare.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2

Literatur

  1. Ahnfelt L, Herberts P, Malchau H, Andersson GB (1990) Prognosis of total hip replacement. A Swedish multicenter study of 4,664 revisions. Acta Orthop Scand 238(Suppl): 1–26

    Google Scholar 

  2. Blasius K, Cotta H, Schneider U, Thomsen M (1993) CLS multicenter study – 8-year results. Z Orthop Ihre Grenzgeb 131(6): 547–552

    PubMed  Google Scholar 

  3. Breusch SJ, Aldinger PR, Thomsen M et al. (2000) Anchoring principles in hip prosthesis implantation. II: Acetabulum components. Unfallchirurg 103(12): 1017–1031

    Article  PubMed  Google Scholar 

  4. Brooker AF, Bowerman JW, Robinson RA, Riley LH Jr (1973) Ectopic ossification following total hip replacement. Incidence and a method of classification. J Bone Joint Surg Am 55(8): 1629–1632

    PubMed  Google Scholar 

  5. Cech O, Dzupa V, Svatos F (2001) The uncemented cup of the CLS Spotorno joint endoprosthesis – 5-years‘ results. Acta Chir Orthop Traumatol Cech 68(1): 10–17

    PubMed  Google Scholar 

  6. DeLee JG, Charnley J (1976) Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop 121: 20–32

    PubMed  Google Scholar 

  7. Eingartner C, Ihm A, Maurer F et al. (2002) Good long term results with a cemented straight femoral shaft prosthesis made of titanium. Unfallchirurg 105(9): 804–810

    Article  PubMed  Google Scholar 

  8. Ender SA, Machner A, Pap G et al. (2005) Long-term results with the Harris-Galante press-fit-cup. Z Orthop Ihre Grenzgeb 143(3): 348–354

    Article  PubMed  Google Scholar 

  9. Engh CA, Griffin WL, Marx CL (1990) Cementless acetabular components. J Bone Joint Surg Br 72(1): 53–59

    PubMed  Google Scholar 

  10. Goodman S (2005) Wear particulate and osteolysis. Orthop Clin North Am 36(1): 41–48

    Article  PubMed  Google Scholar 

  11. Gruen TA, McNeice GM, Amstutz HC (1979) „Modes of failure“ of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop 141: 17–27

    PubMed  Google Scholar 

  12. Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am 51: 737–55

    PubMed  Google Scholar 

  13. Jacobs JJ, Shanbhag A, Glant TT et al. (1994) Wear debris in total joint replacements. J Am Acad Orthop Surg 2(4): 212–220

    PubMed  Google Scholar 

  14. Kim YH, Kim JS, Cho SH (1999) Primary total hip arthroplasty with the AML total hip prosthesis. Clin Orthop 360: 147–158

    Article  PubMed  Google Scholar 

  15. Koseki H, Matsumoto T, Ito S et al. (2005) Analysis of polyethylene particles isolated from periprosthetic tissue of loosened hip arthroplasty and comparison with radiographic appearance. J Orthop Sci 10(3): 284–290

    Article  PubMed  Google Scholar 

  16. Malchau H, Herberts P, Ahnfelt L (1993) Prognosis of total hip replacement in Sweden. Follow-up of 92,675 operations performed 1978–1990. Acta Orthop Scand 64(5): 497–506

    PubMed  Google Scholar 

  17. Malchau H, Herberts P, Eisler T et al. (2002) The Swedish total hip replacement register. J Bone Joint Surg Am 84(Suppl 2): 2–20

    PubMed  Google Scholar 

  18. Maloney WJ, Galante JO, Anderson M et al. (1999) Fixation, polyethylene wear, and pelvic osteolysis in primary total hip replacement. Clin Orthop 369: 157–164

    Article  PubMed  Google Scholar 

  19. Manley MT, Capello WN, D’Antonio JA et al. (1998) Fixation of acetabular cups without cement in total hip arthroplasty. A comparison of three different implant surfaces at a minimum duration of follow-up of five years. J Bone Joint Surg Am 80(8): 1175–1185

    PubMed  Google Scholar 

  20. Modrego FJ, Molina J (2004) Self-expanding cup CLS. 10 years results. Rev Fac Cien Med Univ Nac Cordoba 61(1): 7–12

    Google Scholar 

  21. Rahbek O, Kold S, Bendix K et al. (2005) Superior sealing effect of hydroxyapatite in porous-coated implants: experimental studies on the migration of polyethylene particles around stable and unstable implants in dogs. Acta Orthop 76(3): 375–385

    PubMed  Google Scholar 

  22. Rozkydal Z, Janicek P, Deduch J, Hudecek F (2001) Complications with the acetabular cup in the CLS total hip joint endoprosthesis. Acta Chir Orthop Traumatol Cech 68(2): 85–92

    PubMed  Google Scholar 

  23. Taylor J (2000) 5–13 year results of the Spotorno expansion cup. Acetabulumersatz Meeting, Heidelberg

  24. Thomsen M, Schneider U, Blasius K, Cotta H (1995) Cementless cup anchorage in hip endoprostheses. Comparative study of 3 cup systems with titanium surface. Z Orthop Ihre Grenzgeb 133(6): 551–557

    PubMed  Google Scholar 

  25. Xenos JS, Callaghan JJ, Heekin RD et al. (1999) The porous-coated anatomic total hip prosthesis, inserted without cement. A prospective study with a minimum of ten years of follow-up. J Bone Joint Surg Am 81(1): 74–82

    PubMed  Google Scholar 

Download references

Interessenkonflikt

Es besteht kein Interessenkonflikt. Der korrespondierende Autor versichert, dass keine Verbindungen mit einer Firma, deren Produkt in dem Artikel genannt ist, oder einer Firma, die ein Konkurrenzprodukt vertreibt, bestehen. Die Präsentation des Themas ist unabhängig und die Darstellung der Inhalte produktneutral.

Author information

Authors and Affiliations

  1. Unfallchirurgische Klinik, Medizinische Hochschule Hannover, Carl Neubergstraße 1, 30625, Hannover

    D. Kendoff, C. Strobel, C. Krettek & T. Gerich

Authors
  1. D. Kendoff
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C. Strobel
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. C. Krettek
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. T. Gerich
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to D. Kendoff.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kendoff, D., Strobel, C., Krettek, C. et al. 13-Jahres-Ergebnisse der CLS-Spreizpfanne in der primären Hüftendoprothetik. Unfallchirurg 109, 457–462 (2006). https://doi.org/10.1007/s00113-006-1076-7

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00113-006-1076-7

Schlüsselwörter

Keywords

Search

Navigation