Survival of cemented short Exeter femoral components in primary total hip arthroplasty

Author:

van Veghel Mirthe H. W.1ORCID,van der Koelen Remy E.1ORCID,Hannink Gerjon2ORCID,Schreurs B. W.13ORCID,Rijnen Wim H. C.1ORCID

Affiliation:

1. Department of Orthopaedics, Radboud University Medical Center, Nijmegen, Netherlands

2. Department of Medical Imaging, Radboud University Medical Center, Nijmegen, Netherlands

3. Dutch Arthroplasty Register (Landelijke Registratie Orthopedische Interventies), 's Hertogenbosch, Netherlands

Abstract

AimsThe aim of this study was to report the long-term follow-up of cemented short Exeter femoral components when used in primary total hip arthroplasty (THA).MethodsWe included all primary 394 THAs with a cemented short Exeter femoral component (≤ 125 mm) used in our tertiary referral centre between October 1993 and December 2021. A total of 83 patients (21%) were male. The median age of the patients at the time of surgery was 42 years (interquartile range (IQR) 30 to 55). The main indication for THA was a childhood hip disease (202; 51%). The median follow-up was 6.7 years (IQR 3.1 to 11.0). Kaplan-Meier survival analyses were performed to determine the rates of survival with femoral revision for any indication, for septic loosening, for fracture of the femoral component and for aseptic loosening as endpoints. The indications for revision were evaluated. Fractures of the femoral component were described in detail.ResultsThe 20-year rate of survival was 85.4% (95% confidence interval (CI) 73.9 to 92.0) with revision for any indication, 96.2% (95% CI 90.5 to 98.5) with revision for septic loosening and 92.7% (95% CI 78.5 to 97.6) with revision for fracture of the femoral component. No femoral components were revised for aseptic loosening. There were 21 revisions of the femoral component; most (seven) as part of a two-stage management of infection. Fracture of the femoral component occurred in four THAs (1.0%) at 6.6, 11.6, 16.5, and 18.2 years of follow-up, respectively. Three of these were transverse fractures and occurred at the level of the lesser trochanter. In one THA, there was a fracture of the neck of the component.ConclusionTHAs using cemented short Exeter femoral components showed acceptable rates of survival of the femoral component at long-term follow-up, in this young cohort of patients. Although fracture is a rare complication of these components, surgeons should be aware of their incidence and possible risk factors.Cite this article: Bone Joint J 2024;106-B(3 Supple A):137–142.

Publisher

British Editorial Society of Bone & Joint Surgery

Reference25 articles.

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2. Ben-Shlomo Y , Blom A , Boulton C . The National Joint Registry 19th Annual Report 2022 . London, UK: National Joint Registry . 2022 . https://reports.njrcentre.org.uk/Portals/0/PDFdownloads/NJR%2019th%20Annual%20Report%202022.pdf ( date last accessed 11 January 2024 ).

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4. Long-Term Success with a Double Tapered Polished Straight Stem

5. Experience with primary Exeter total hip arthroplasty in patients with small femurs. Review at average follow-up period of 6 years;Chiu;J Arthroplasty,1997

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