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Exeter Universal hip implant continues showing long-term success

At latest follow-up, researchers found cases of revision due to aseptic loosening of the stem.

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GLASGOW, Scotland — The Exeter Universal hip implant continues to show success at 15 to 17 years' follow-up, according to a study by surgeons in the United Kingdom.

Nicholas C. Carrington, FRCS(Tr&Orth), and colleagues at the Princess Elizabeth Orthopaedic Center in Exeter, England, reviewed the long-term results for the first 325 hips implanted with the Exeter Universal hip implant (Stryker Orthopaedics). Carrington presented the results here at the 2006 British Orthopaedic Association Annual Congress.

The data analysis included 325 hips in 309 patients. No patients had been lost to follow-up at a mean 15.7 years, including 191 patients who died with the implant remaining in situ, Carrington said.

According to the study, researchers found no cases with radiological evidence of femoral failure. At latest follow-up, patients had the following mean clinical and functional scores:

• Charnley pain scores, 5.4;
• Charnley function scores, 4.8;
• Oxford Hip scores, 21.6; and
• Harris Hip pain and function scores, 71.7.

Surgeons revised or reimplanted 31 of the implants, but "there have been no revisions for aseptic loosening of the stem, [although] 4% of sockets have been revised for aseptic loosening so far," Carrington said.

Surgeons used metal-backed sockets for 97% of hips. However, most surgeons stopped using metal-backed sockets in 1990, around the time this study began, he noted.

Carrington and colleagues had previously evaluated the original version of the implant — the Exeter Stem — which also yielded good long-term results.

"The 15-year results of the Exeter Universal Stem [show] practically no change from using the original Exeter stem," Carrington said. "The radiological evidence suggests the new stem transmits load in the same way as the original stem."

Surgeons at the Princess Elizabeth Orthopaedic Center use the Exeter Universal Stem in all cases, independent of patient age, pathology, bone quality or femoral deformity, Carrington noted.

For more information:

• Carrington NC, Sierra R, Hubble MW, et al. The Exeter Universal cemented femoral component at 14 to 17 years: an update on the first 325 hips. Presented at the 2006 British Orthopaedic Association Annual Congress. Sept. 27-29, 2006. Glasgow, Scotland.