Assessment of the equivalence of a generic to a branded femoral stem

Author:

Hothi H.1,Henckel J.1,Shearing P.2,Holme T.1,Cerquiglini A.1,Laura A. Di1,Atrey A.3,Skinner J.1,Hart A.1

Affiliation:

1. Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Stanmore, UK.

2. University College London, Torrington Place, London, UK.

3. University of Toronto and St Michael’s Hospital, Toronto, Canada.

Abstract

Aims The aim of this study was to compare the design of the generic OptiStem XTR femoral stem with the established Exeter femoral stem. Materials and Methods We obtained five boxed, as manufactured, implants of both designs at random (ten in total). Two examiners were blinded to the implant design and independently measured the mass, volume, trunnion surface topography, trunnion roughness, trunnion cone angle, Caput-Collum-Diaphyseal (CCD) angle, femoral offset, stem length, neck length, and the width and roughness of the polished stem shaft using peer-reviewed methods. We then compared the stems using these parameters. Results We found that the OptiStems were lighter (p < 0.001), had a rougher trunnion surface (p <  0.001) with a greater spacing and depth of the machined threads (p < 0.001), had greater trunnion cone angles (p = 0.007), and a smaller radius at the top of the trunnion (p = 0.007). There was no difference in stem volume (p = 0.643), CCD angle (p = 0.788), offset (p = 0.993), neck length (p = 0.344), stem length (p = 0.808), shaft width (p = 0.058 to 0.720) or roughness of the polished surface (p = 0.536). Conclusion This preliminary investigation found that whilst there were similarities between the two designs, the generic OptiStem is different to the branded Exeter design. Cite this article: Bone Joint J 2017;99-B:310–16.

Publisher

British Editorial Society of Bone & Joint Surgery

Subject

Orthopedics and Sports Medicine,Surgery

Reference17 articles.

1. The NJR Editorial Board. 13th Annual Report of the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man. http://www.njrcentre.org.uk/njrcentre/Reports,PublicationsandMinutes/Annualreports/tabid/86/Default.aspx (date last accessed 20 December 2016).

2. No authors listed. Total Hip Replacement. http://orthoinfo.aaos.org/topic.cfm?topic=a00377 (date last accessed 20 December 2016).

3. The manufacture of generic replicas of implants for arthroplasty of the hip and knee

4. The Exeter Universal cemented femoral stem at 20 to 25 years

5. Performance of the CLS Spotorno uncemented stem in the third decade after implantation

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