The Long-Term Results of the Original Exeter Polished Cemented Femoral Component

Ling, R. S. M.; Charity, John; Lee, A.J. Clive; Whitehouse, Sarah L.; Timperley, A. John; Gie, Graham A.

doi:10.1016/j.arth.2009.02.002

Cited by 108 publications

(56 citation statements)

References 16 publications

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“…Despite this, the literature on its survival is sparse. 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.…”

Section: Discussionmentioning

confidence: 73%

“…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.…”

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confidence: 99%

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

Burston¹,

Barnett²,

Amirfeyz

et al. 2012

The Journal of Bone and Joint Surgery. British volume

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We prospectively followed 191 consecutive collarless polished tapered (CPT) femoral stems, implanted in 175 patients who had a mean age at operation of 64.5 years (21 to 85). At a mean follow-up of 15.9 years (14 to 17.5), 86 patients (95 hips) were still alive. The fate of all original stems is known. The 16-year survivorship with re-operation for any reason was 80.7% (95% confidence interval 72 to 89.4). There was no loss to follow-up, with clinical data available on all 95 hips and radiological assessment performed on 90 hips (95%). At latest follow-up, the mean Harris hip score was 78 (28 to 100) and the mean Oxford hip score was 36 (15 to 48). Stems subsided within the cement mantle, with a mean subsidence of 2.1 mm (0.4 to 19.2). Among the original cohort, only one stem (0.5%) has been revised due to aseptic loosening. In total seven stems were revised for any cause, of which four revisions were required for infection following revision of the acetabular component. A total of 21 patients (11%) required some sort of revision procedure; all except three of these resulted from failure of the acetabular component. Cemented acetabular components had a significantly lower revision burden (three hips, 2.7%) than Harris Galante uncemented components (17 hips, 21.8%) (p < 0.001).The CPT stem continues to provide excellent radiological and clinical outcomes at 15 years following implantation. Its results are consistent with other polished tapered stem designs.

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Section: Discussionmentioning

confidence: 73%

mentioning

confidence: 99%

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

Burston¹,

Barnett²,

Amirfeyz

et al. 2012

The Journal of Bone and Joint Surgery. British volume

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“…The majority of these studies (10 of 13) were performed on the Charnley THA (Formerly Thackery, now DePuy, Leeds, UK, or Zimmer, Warsaw, IN, USA) with three additional long-term studies performed on the Harris Design-2 (Howmedica, East Rutherford, NJ, USA) [19], Exeter (Stryker, Newbury, UK) [16], and Müller straight stem (Zimmer, Winterthur, Switzerland) [8].…”

Section: Methodsmentioning

confidence: 99%

“…Kaplan-Meier survivorship at 20 years for the endpoint of revision of the femoral component for aseptic loosening ranged from 86% to 98% survival for studies reporting this data [8,14,16,22,23]. Even in the worst-case scenario analysis performed by Ling et al [16], in which all hips with unknown revision status at minimum 20 years were considered to be revised for aseptic loosening, Kaplan-Meier survivorship at 20 years was still 85.6% at the endpoint revision of femoral component for aseptic loosening.…”

Section: Aseptic Looseningmentioning

confidence: 99%

Systematic Review of Literature of Cemented Femoral Components: What Is the Durability at Minimum 20 Years Followup?

Bedard

Callaghan

Stefl³

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Cemented femoral total hip arthroplasty may be one of the most successful surgical interventions of all time. However, although results are very encouraging over the early to mid-term followup, relatively few studies have analyzed the durability of these implants beyond 20 years followup. To evaluate the performance of contemporary implants, it is important to understand how previous implants perform at 20 or more years of followup; one way to do this is to aggregate the available data in the form of a systematic review. Questions/purposes (1) How durable is cemented femoral fixation in the long term (minimum 20-year followup) with respect to aseptic loosening? (2) Is the durability of cemented femoral fixation dependent on age of the patient? (3) Are the long-term results of the cemented femoral fixation dependent on any identifiable characteristics of the prosthesis such as surface finish? Methods A systematic review was performed to identify long-term studies of cemented femoral components. After application of inclusion and exclusion criteria to 1228 articles found with a search in PubMed and EMBASE, 17 studies with a minimum of 20-year followup on cemented femoral components were thoroughly analyzed in an attempt to answer the questions of this review. The quality of the studies reviewed was assessed with the Methodological Index for Nonrandomized Studies (MINORS) instrument. All studies were case series and cohort sizes ranged from 110 to 2000 hips for patients older than 50 years of age and 41 to 93 hips for patients younger than 50 years at the time of surgery. Results Among the six case series performed in patients older than 50 years of age, survivorship for aseptic loosening of the femoral component ranged from 86% to 98% at 20 years followup. There were no obvious differences for younger patients when analyzing the five studies in patients younger than age 50 years in which survivorship free from aseptic loosening for these studies ranged from 77% at 20 years in one study and 68% to 94% at 25 years in the other studies. Although data pooling could not be performed because of heterogeneity of the studies included here, it appeared that stems with a rougher surface finish did not perform as well as polished stems; survivorship of stems with rougher surface finishes varied between 86% and 87%, whereas those with smoother finishes ranged between 93.5% and 98% at 20 years. Conclusions Excellent long-term fixation in both older and younger patients can be obtained with cemented,

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“…The polished collarless double-taper femoral stems, including the Exeter TM (Stryker Howmedica Osteonics, Berkshire, UK) and CPT 1 (Zimmer, Inc, Warsaw, IN, USA), are associated with high survival rates in older patients [10,16,22,35,36]. 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.…”

Section: Introductionmentioning

confidence: 99%

Femoral Bone Is Preserved Using Cemented Polished Stems in Young Patients

Howie

Costi

McGee

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Techniques that ensure femoral bone preservation after primary THA are important in younger patients who are likely to undergo revision surgery. Questions/purposes We examined femoral stem survival, bone deficiency at revision arthroplasty, and radiographic bone loss in hips implanted with a cemented polished double-taper stem in a cohort of patients younger than 55 years. Methods We reviewed 197 hips (median patient age, 47 years; range, 16-54 years) after a minimum followup of 2 years (median, 7 years; range, 2-19 years) since primary THA. Clinically, we determined survival to major and minor stem revision and cases of bone deficiency requiring a long stem or impaction bone grafting or created by the need for femoral osteotomy at revision arthroplasty. Radiographically, we assessed stem loosening, femoral osteolysis, and femoral bone deficiency. Results Stem survival to major revision for aseptic loosening was 100% at 13 years and for any reason was 97% (95% CI, 93-

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The Long-Term Results of the Original Exeter Polished Cemented Femoral Component

Cited by 108 publications

References 16 publications

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

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

Systematic Review of Literature of Cemented Femoral Components: What Is the Durability at Minimum 20 Years Followup?

Femoral Bone Is Preserved Using Cemented Polished Stems in Young Patients

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