The Exeter™ Universal Hip in Patients 50 Years or Younger at 10-17 Years' Followup

Abstract

The Exeter TM Universal hip (Stryker Inc., Newbury, UK) has reported survival rates of 91.74% at 12 years in all patients with reoperation as an endpoint. However, its performance in younger patients has not been fully established. We reviewed survivorship and the clinical and radiographic outcomes of this hip system implanted in 107 patients (130 hips) 50 years old or younger at the time of surgery. The mean age at surgery was 42 years. The minimum followup was 10 years (mean, 12.5 years; range, 10-17 years) with no patients lost to followup. Twelve hips had been revised. Of these, nine had aseptic loosening of the acetabular component and one cup was revised for focal lysis and pain. One hip was revised for recurrent dislocation and one joint underwent revision for infection. Radiographs demonstrated 14 (12.8%) of the remaining acetabular prostheses were loose but no femoral components were loose. Survivorship of both stem and cup from all causes was 92.6% at an average of 12.5 years. Survivorship of the stem from all causes was 99% and no stem was revised for aseptic loosening. The Exeter TM

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.…”

“…Consistent with similar studies [6,21], infection and periprosthetic fracture, and not linear or nonlinear osteolysis, brought stems to revision and were the causes of bone deficiency. Two-stage exchange, femoral impaction bone grafting, and revision to a standard-length stem successfully treated the bone deficiency in one infected hip, which we have reported previously [17].…”

“…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. Their series of 130 hips with Exeter TM stems involved both Exeter TM -based specialist hip surgeons (68%) and general orthopaedic surgeons (32%).…”

“…Stem survival to the end point of loosening is reportedly 100% at 12.5 years in younger patients when performed by specialist hip surgeons [3,21], although such high survival may not necessarily reflect those of the general orthopaedic surgeon. General orthopaedic surgeons have a shared case load of arthroplasty, general orthopaedics, and orthopaedic trauma but usually perform most THAs in public hospitals.…”

Cementless Total Hip Arthroplasty With Metasul Bearings Provides Good Results in Active Young Patients: A Concise Followup

“…Femoral component fixation in patients younger than 50 years old is less debated today than at the onset of our experience. Modern cementing techniques and cementless femoral components showed good results with 10-year survival rates regularly greater than 95% [1,5,31,33,35,[46][47][48]. In this study, none of the 83 Alloclassic-SL stems have been revised for aseptic loosening after a median followup of 13 years in situ indicating that this cementless grit-blasted titanium straight taper design was well adapted to the standard femoral configuration selected according to the inclusion criteria.…”