The use of the cemented Exeter Universal femoral stem in a District General Hospital

Abstract

We describe the survivorship of the Exeter femoral component in a District General Hospital. Between 1994 and 1996, 230 Exeter Universal cemented femoral components were implanted in 215 patients who were reviewed at a mean of 11.2 years (10 to 13). We used one acetabular implant, the Elite Ogee component, in 218 of the 230 hips. During the period of this study 76 patients (79 hips) died. Of the remaining 139 patients (151 hips), 121 were able to attend for radiological analysis at a minimum of ten years. One patient was lost to follow-up. No femoral component was revised for aseptic loosening. Three hips were revised for deep infection and six acetabular components required revision, four for loosening and two for recurrent dislocation. Taking the 'worst-case scenario' including the one patient lost to follow-up, the overall survival rate was 94.4% at 13 years. Our results confirm excellent medium-term results for the Exeter Universal femoral component, implanted in a general setting. The excellent survival of this femoral component, when used in combination with the Ogee acetabular component, suggests that this is a successful pairing.

Risk Factors for Revision of Hip Arthroplasties in Patients Younger Than 30 Years

“…We found cementless or cemented primary THA prostheses designs had no correlation with revision probability. The literature seems to agree with these data showing comparable revision rates after THA implantation of cemented or cementless implants in the general population [24,39]. In patients younger than 30 years, with 6 years' followup, Restrepo et al [29] reported only one revision with cementless implants, with excellent bone stock ongrowth.…”

Femoral Bone Is Preserved Using Cemented Polished Stems in Young Patients

“…Our stem survival of 100% is consistent with the published studies of cemented polished double-taper stems in similarly aged patients [3,6,21,32] (Table 3). Importantly, these survival rates in young patients often with complex hip disorders were also comparable to those for longer-term followups of this stem design in older patients [3,6,10,16,21,32,37] (Table 3). Lewthwaite et al [21] reported 17-year stem survivals of 100% and 99% for the end points of revision for stem loosening and for any reason, respectively, in young patients.…”

Clinical and radiological results of the collarless polished tapered stem at 15 years follow-up

“…14,29,30 This is in stark contrast to the Exeter design, from which the CPT was derived, which has excellent clinical and radiological followup in both its originating centre [1][2][3][4][5] and elsewhere. 6,7 This study follows the same cohort of patients previously reported at a minimum of ten years post-operatively.…”

“…The impressive survival of collarless polished double tapered femoral components has been demonstrated in originator series, [1][2][3][4][5] in nonoriginator series 6 and non-teaching centres 7 and in registry data. 8,9 There have been predictable patterns of subsidence at the stemcement interface, 10 a factor that has been suggested to confer stability to the stem 11 and provide protection to the cement-bone interface.…”