title: Exeter small femoral stem for patients with small femurs.
abstract: OBJECTIVE
  To report the long-term results of total hip arthroplasty (THA) using small size Exeter femoral stems.
  
  
  METHODS
  Eight men and 34 women aged 60 to 83 (mean, 70) years underwent 45 THAs using the Exeter small stem with offsets of 30 mm (n=3), 33 mm (n=15), and 35.5 mm (n=27). The Harris hip score was assessed pre- and post-operatively. Stem alignment and axial subsidence of the stem were measured. Radiolucent lines around the femur were recorded at 14 Gruen zones. Completeness and thickness of the cement mantle and cement fractures were also noted. Ectopic ossification, if present, was graded. Stem loosening was based on the Olsson definitions.
  
  
  RESULTS
  The mean follow-up was 9 (range, 5-12) years. The mean Harris hip score improved from 37 (range, 13-61) to 80 (range, 47-96) [p<0.001]. At the latest follow-up, the score was excellent (90-100) in 8 (18%) of the hips, good (80-89) in 21 (47%), fair (70-79) in 9 (20%), and poor (<70) in 7 (16%). All hips had a complete cement mantle of 2 mm or more. All stems were inserted without intramedullary reaming. 11 (24%) of the hips developed stem subsidence of <2 mm; all stabilised within 2 years. None of these patients had pain or other radiological signs of loosening. Six stems showed radiolucent lines of <1 mm in the upper zones, which were not progressive. No cement fracture or subsidence was noted. Using revision for any cause as an endpoint, the overall survival rate of Exeter small femoral stem was 100% at 10 years and 89% at 12 years.
  
  
  CONCLUSIONS
  The results of Exeter small stems for patients with small femurs are good.
authors.affiliation: Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong. khchiu@ort.cuhk.edu.hk
authors.forename: Kwok-hing
authors.initials: KH
authors.lastname: Chiu
authors.forename: Kin-wing
authors.initials: KW
authors.lastname: Cheung
authors.forename: Kwong-yin
authors.initials: KY
authors.lastname: Chung
authors.forename: Wan-yiu
authors.initials: WY
authors.lastname: Shen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D002484:Cementation; D005260:Female; D005269:Femur / Q000033:anatomy & histology*; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011475:Prosthesis Failure; D017755:Prosthesis Fitting; D012086:Reoperation / Q000706:statistics & numerical data; D016896:Treatment Outcome