Abstract

Indications and results of the cement-free SL femoral stem. The SL femoral stem was designed to revise loosened femoral implants with extensive bone resorption and damage in the prosthetic bed. The stem bridges the damaged proximal area and the specific elasticity of the bridging part produces favourable conditions for new bone formation, whereas the distal section with 8 conical anchorage ribs allows a distal cementless fixation. Since 1987, 25 SL-revision stems were implanted at the Ziegler Hospital in Berne. Indications: aseptic loosening with extensive bone loss = 16; periprosthetic femoral fractures = 6; Girdlestone after removal of infected THA = 2; unstable infected osteosynthesis of a proximal femoral fracture = 1. As described elsewhere, our revisions showed an impressive bone remodelling in the proximal femur damaged area with an osseointegration of the titanium stem, as could be shown histologically on a retrieved specimen of one of our cases. The Wagner stem proved to be an ideal implant to treat periprosthetic femur fractures in cases with loss of bone stock. The postoperative complications were low compared with the severity of the cases. Infections 0; aseptic loosening 1: replaced with a bigger and longer stem; luxations 4.