Primary Exeter Total Hip Arthroplasty in Patients With Small Femurs

Chiu, Kwong Yuen; Wang, Shen; Cheung, Kwok W.; Tsui, Hon For

doi:10.1016/j.arth.2004.01.014

Cited by 32 publications

(27 citation statements)

References 22 publications

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“…However, we have considered that massive subsidence may be related to splitting of the cement mantle and some movement between the cement and graft and that early massive subsidence may result from a failure to obtain initial stability. Concerning the sizes of the stems, we used two smaller stems [AP1 (30 mm), AP2 (33 mm)] that were developed in Hong Kong for small femurs in Asian patients [2] (Table 4). The body weights and heights of the South Korean patients in our study (average: 56 kg and 157 cm, respectively) were smaller than those of Western patients; femur stems smaller than the usual stem [no.…”

Section: Discussionmentioning

confidence: 99%

Impaction allograft with cement for the revision of the femoral component. A minimum 39-month follow-up study with the use of the Exeter stem in Asian hips

Yim

Kim

Suh

2006

International Orthopaedics (SICOT)

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We report the results of impaction bone grafting of the femoral side in revision total hip arthroplasty in Asian hips (South Korean patients) in which the surgery was performed with the Exeter stem. The minimum follow-up was 39 months (mean, 48.4; range, 39-66). There was subsidence of the cement-graft interface (<1 mm) in three hips (5%), of the stem-cement interface (<1 mm) in 12 hips (21%) and of the stem-cement interface (1-2 mm) in 14 hips (25%). Five hips (9%) developed intraoperative femoral fracture and two hips (4%) femoral perforation in revision. The complications of femoral fracture and subsidence did not have an adverse effect on the final clinical outcomes. The impaction of fresh-frozen allograft and use of a cemented, polished, tapered stem (Exeter stem) were also successful with good clinical and radiographic outcomes in our study of Asian hips (South Korean patients). However, we used smaller stems than the usual ones used for Western patients because of the smaller femur sizes.Résumé Nous reportons les résultats de la technique d'Exeter avec greffons impactés dans les reprises totales de hanche, étude réalisée sur des hanches asiatiques et sur des patients sud coréens, avec utilisation de la tige d'Exeter.Le suivi minimum a été de 39 mois (48.4 à 39.66). La migration à l'interface ciment greffe a été inférieure à 1 mm dans 3 cas, 5%. A l'interface tige ciment, (<1 mm) dans 12 hanches (21% des cas) et enfin à l'interface tige ciment, cette migration est comprise entre 1 et 2 mm dans 14 hanches (25% des cas). 5 hanches (11%) ont présenté durant l'intervention des complications avec une fracture fémorale dans 5 cas (9%) et une perforation fémorale dans 2 cas (4%). Ces complications ainsi que la migration de la tige n'ont pas entraîné de problèmes cliniques. La technique utilisant des allogreffes compactées cryoconservées et l'utilisation d'une tige cimentée et polie de type Exeter ont donné, dans cette étude, de bons résultats, tant sur le plan clinique que sur le plan radiographique. Cependant, nous avons dû utiliser des tiges beaucoup plus petites qu'habituellement en Europe compte tenu de la petite taille des fémurs asiatiques sud coréens.

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Section: Discussionmentioning

confidence: 99%

Impaction allograft with cement for the revision of the femoral component. A minimum 39-month follow-up study with the use of the Exeter stem in Asian hips

Yim

Kim

Suh

2006

International Orthopaedics (SICOT)

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“…In the subsequent 5 years following its availability, CDH or smaller stems were used in 73.2% of Exeter total hip arthroplasties [3]. No stem failure was observed at the time of Chiu's reporting [3,4]. Fujita [20], Sivananthan [21], and Tai [22] from different Asian centers also reported their results of small Exeter stem implanted for primary and revision total hip arthroplasties, with no stem fracture observed.…”

Section: Discussionmentioning

confidence: 89%

“…5) have been made available to this population since 1998. In the subsequent 5 years following its availability, CDH or smaller stems were used in 73.2% of Exeter total hip arthroplasties [3]. No stem failure was observed at the time of Chiu's reporting [3,4].…”

Section: Discussionmentioning

confidence: 98%

“…Oversizing of the stem and incomplete or inadequate cement mantle might account for the early loosening. Among 27 stems considered oversized with inadequate or incomplete cement mantle, the failure rate was 22.2%, while none of those with adequate cement mantle failed [3]. In those 27 oversized stem, smallest size stem in the study period were used in 18 hips.…”

Section: Discussionmentioning

confidence: 99%

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The Asian size Exeter femoral stem fracture

Chung

Cheung

Chiu

et al. 2016

Journal of Orthopaedic Science

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“…1,3,[8][9][10] Nonetheless, it is important to match the prosthesis size to achieve Table 2 Distal contact in femurs with a 150-mm versus 125-mm rasp optimal outcome. 11 In patients with a narrow femoral canal, the 150-mm stem is too wide and necessitates additional reaming to remove the cancellous bone including the strongest trabecular bone near the corticocancellous bone junction (within 3 mm of the cortex), which is the ideal bed for cement fixation. 12 Many of the femoral components are too large for patients with a small femoral canal, resulting in cement mantle <2 mm thick.…”

Section: Discussionmentioning

confidence: 99%