The Exeter V40 cemented femoral component at a minimum 10-year follow-up: The first 540 cases

Aims : In 2000, the Exeter femoral stem became available in the current V40 design. We report the results of the first 540 Exeter V40 femoral stems performed in our unit between December 2000 and May 2002. Patients and Methods : Routine protocol was to review patients postoperatively and at 1, 5 and 10 years following surgery. Results : Ten years after surgery there are no stem revisions for aseptic loosening and no evidence of aseptic loosening in any hip. The fate of every implant is known and all patients remain under review. Survivorship, with revision of the femoral component for aseptic loosening as the endpoint, was 100%. One hundred and forty-five patients (26.9%) died before 10 years and of the remaining 395 stems, 374 (94.7%) remain in situ. Eleven stems were revised (2.8%): one for stem fracture, six following a peri-prosthetic fracture, one for instability and three consequent upon deep infection. Ten well-fixed stems were also exchanged using a cement-in-cement technique to facilitate cup revision. An additional 16 cups were revised (4.1%): five for aseptic loosening and 11 for instability. At 13.5 years, the Kaplan-Meier survival rate for all cause stem revision was 96.8% (95% CI 94.8 to 98.8%) and all cause hip revision (including cup revision, infection and instability) was 91.2% (95% CI 88.3 to 94.1%). Conclusion : There were no stem revisions for aseptic loosening. The contemporary Exeter V40 stem continues to perform well and survival has remained comparable with the Exeter Universal stem.