The Exeter Universal cemented femoral stem at 20 to 25 years: A report of 382 hips.
OBJECTIVE
We present a minimum 20-year follow-up study of 382 cemented Exeter Universal total hip arthroplasties (350 patients) operated on at a mean age of 66.3 years (17 to 94).


METHODS
All patients received the same design of femoral component, regardless of the original diagnosis. Previous surgery had been undertaken for 33 hips (8.6%). During the study period 218 patients with 236 hips (62%) died, 42 hips (11%) were revised and 110 hips (29%) in 96 patients were available for review. The acetabular components were varied and some designs are now obsolete, however they were all cemented.


RESULTS
With an endpoint of revision for aseptic loosening or lysis, survivorship of the stem at 22.8 years was 99.0% (95% confidence interval (CI) 97.0 to 100). One stem was revised 21 years post-operatively in a patient with Gaucher's disease and proximal femoral osteolysis. Survivorship with aseptic loosening or lysis of the acetabular component or stem as the endpoint at 22.8 years was 89.3% (95% CI 84.8 to 93.8). With an endpoint of revision for any reason, overall survivorship was 82.9% (95% CI 77.4 to 88.4) at 22.8 years. Radiological review showed excellent preservation of bone stock at 20 to 25 years, and no impending failures of the stem.


CONCLUSIONS
The Exeter femoral stem continues to perform well beyond 20 years. Cite this article: Bone Joint J 2016;98-B:1441-9.
The Princess Elizabeth Orthopaedic Centre, Exeter EX2 5DW, UK.
T G
TG
Petheram
Queensland University of Technology, Brisbane, Queensland, Australia.
S L
SL
Whitehouse
The Princess Elizabeth Orthopaedic Centre, Exeter EX2 5DW, UK.
H A
HA
Kazi
The Princess Elizabeth Orthopaedic Centre, Exeter EX2 5DW, UK.
M J W
MJ
Hubble
The Princess Elizabeth Orthopaedic Centre, Exeter EX2 5DW, UK.
A J
AJ
Timperley
The Princess Elizabeth Orthopaedic Centre, Exeter EX2 5DW, UK.
M J
MJ
Wilson
The Princess Elizabeth Orthopaedic Centre, Exeter EX2 5DW, UK.
J R
JR
Howell
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation*; D001843:Bone Cements; D002484:Cementation; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000601:surgery; D005500:Follow-Up Studies; D005776:Gaucher Disease / Q000000981:diagnostic imaging / Q000601:surgery; D006622:Hip Prosthesis; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010014:Osteolysis / Q000000981:diagnostic imaging / Q000601:surgery; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation; D012720:Severity of Illness Index; D055815:Young Adult
D001843:Bone Cements
Cement; Exeter hip; Long-term follow-up; Primary total hip arthroplasty; Survival