The Exeter Universal cemented femoral stem at 20 to 25 years: A report of 382 hips

We report a minimum 20-year follow-up study of 382 total hip replacements in 350 patients with mean age 66.3 years (range 17-94) at operation. All patients received the same design of femoral component, regardless of the original diagnosis, 33 (8.6%) hips had undergone previous surgery. Over the study period 218 patients with 236 (62%) hips died, 42 (11%) hips were revised and 110 (29%) hips in 96 patients were available for review. All acetabular components were cemented, however the components themselves varied and are now obsolete. With an endpoint of revision for aseptic loosening or lysis, stem survivorship at 22.8 years was 99.0% (95% CI 97.0 to 100%). The one stem revised was a patient with Gaucher’s disease and proximal femoral osteolysis 21 years after implantation. Survivorship for aseptic loosening or lysis of cup or stem at 22.8 years was 89.3% (95% CI 84.8 to 93.8%). Overall survivorship of the hips with revision for any reason as endpoint was 82.9% (95% CI 77.4 to 88.4%) at 22.8 years. Radiological review showed excellent preservation of bone stock at 20-25 years, and no impending failures of the femoral component. The Exeter femoral component continues to perform well beyond 20 years.