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Excellent long-term outcomes with an anatomic cementless stem (SPS Evolution) designed using a CT-scan database and inserted with 3D CT-scan preoperative planning: A prospective cohort study - 17/04/25

Doi : 10.1016/j.otsr.2025.104245 
Elhadi Sariali , Sena Boukhelifa
 Hôpitaux Universitaires La Pitié Salpêtrière-Charles-Foix, AP-HP, F-75013, Paris, France 

Corresponding author.
En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Thursday 17 April 2025
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Abstract

Background

Recently, improved hip reconstruction accuracy after total hip arthroplasty (THA) was reported with a specific anatomic stem featuring helicoidal torsion and a double sagittal curvature (SPS Evolution™), compared to the standard double-tapered straight stem, which remains the most widely used design globally. However, no studies have analyzed the ten-year outcomes of THA using this stem. The objective of this study was to assess the survivorship of SPS Evolution™ at ten-year follow-up.

Hypothesis

The use of the modified SPS Evolution™ design provides excellent long-term fixation, a low risk of stress shielding and thigh pain, and a reduced dislocation rate.

Material and methods

A prospective cohort study included 134 consecutive patients who underwent surgery between December 2011 and December 2013. An anatomic stem (SPS Evolution™) with exclusive proximal surface treatment, a cementless acetabular component, and a Delta ceramic-ceramic bearing couple were used in all patients. In total, 102 patients (118 hips), with a mean age of 60 ± 11 years (range, 32–83 years), were evaluated after an average follow-up of 10.6 ± 0.6 years (range, 10–12 years), using the Harris Hip Score (HHS) and the Oxford Hip Score (OHS) self-assessment questionnaires. The fixation and stability of the femoral stem were assessed using the Engh and ARA scores.

Results

An early femoral revision was performed on a 69-year-old woman following a post-traumatic femoral fracture. With aseptic loosening as the endpoint, the survival rate was 100% in 118 hips (95% CI, 96.7–100%) at 10 years. Excellent clinical outcomes were observed, with a mean HHS score of 97.6 ± 6.2 (range, 69–100) and an OHS score of 44.9 ± 5.2 (range, 23–48). All stems were found to be stable and well-osseointegrated.

Discussion

The SPS Evolution™ stem demonstrated an excellent ten-year survival rate. In addition to precise hip reconstruction, it provided excellent clinical and radiological outcomes, indicating that the SPS Evolution™ is a reliable and "conservative" implant.

Level of evidence

IV, prospective cohort study without control group.

El texto completo de este artículo está disponible en PDF.

Keywords : Total hip arthroplasty, Survivorship, Anatomic stem, SPS evolution™


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© 2025  The Authors. Publicado por Elsevier Masson SAS. Todos los derechos reservados.
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