Is osteoporosis or age a contra-indication for the use of the SL-PLUS® stem?
No, on the contrary. It seems that titanium stems, including those that are coated proximally with HA, have a particularly favourable effect on osteoporotic bone, although design remains an important factor. Models anchored proximally are less suitable than those anchored distally as the latter are secured in cortical bone. Although blood circulation through the medullary canal decreases with age, periostal blood supply to the cortical bone shows a relative increase. In old age cortical bone is more reactive than cancellous bone and bone apposition is even seen in older patients with different degrees of osteoporosis. Age is therefore not a contraindication even if cancellous bone is no longer present.
