Standard versus short stem cemented Exeter® when used for primary total hip arthroplasty: a survivorship analysis
Abstract Aims The aims were to compare the survival of the cemented standard (150 mm) with the short (DDH [35.5 mm offset or less], number 1 short stem [125 mm options of 37.5 mm, 44 mm, 50 mm offset] and revision [44/00/125]) Exeter ® V40 femoral stems when used for primary total hip arthroplasty (...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-09-01
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| Series: | Arthroplasty |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s42836-023-00200-8 |
| _version_ | 1797578168739037184 |
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| author | Nick D. Clement Liam Z. Yapp Leo D. Baxendale-Smith Deborah MacDonald Colin R. Howie Paul Gaston |
| author_facet | Nick D. Clement Liam Z. Yapp Leo D. Baxendale-Smith Deborah MacDonald Colin R. Howie Paul Gaston |
| author_sort | Nick D. Clement |
| collection | DOAJ |
| description | Abstract Aims The aims were to compare the survival of the cemented standard (150 mm) with the short (DDH [35.5 mm offset or less], number 1 short stem [125 mm options of 37.5 mm, 44 mm, 50 mm offset] and revision [44/00/125]) Exeter ® V40 femoral stems when used for primary total hip arthroplasty (THA). Methods Patients were retrospectively identified from an arthroplasty database. A total of 664 short stem Exeter ® variants were identified, of which 229 were DDH stems, 208 number 1 stems and 227 revision stems were implanted between 2011 and 2020. A control group of 698 standard Exeter ® stems used for THA was set up, and were followed up for a minimum of 10 years follow-up (implanted 2011). All-cause survival was assessed for THA and for the stem only. Adjusted analysis was undertaken for age, sex and ASA grade. Results The median survival time for the short stems varied according to design: DDH had a survival time of 6.7 years, number 1 stems 4.1 years, and revision stems 7.2 years. Subjects in the short stem group (n = 664) were significantly younger (mean difference 5.1, P < 0.001) and were more likely to be female (odds ratio 1.89, 95% CI 1.50 to 2.39, P < 0.001), compared to the standard group. There were no differences in THA (P = 0.26) or stem (P = 0.35) survival at 5 years (adjusted THA: 98.3% vs. 97.2%; stem 98.7% vs. 97.8%) or 10 years (adjusted THA 97.0% vs. 96.0 %; stem 96.7% vs. 96.2%) between standard and short stem groups, respectively. At 5 years no differences were found in THA (DDH: 96.7%, number 1 97.5%, revision 97.3%, standard 98.6%) or stem (DDH: 97.6%, number 1 99.0%, revision 97.3%, standard 98.2%) survival between/among the different short stems or when compared to the standard group. Conclusion The Exeter ® short stems offer equivocal survival when compared to the standard stem at 5- to 10-year follow-up, which does not seem to be influenced by the short stem design. |
| first_indexed | 2024-03-10T22:18:19Z |
| format | Article |
| id | doaj.art-5c611ff1375d481296f28bff9aa5d351 |
| institution | Directory Open Access Journal |
| issn | 2524-7948 |
| language | English |
| last_indexed | 2024-03-10T22:18:19Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Arthroplasty |
| spelling | doaj.art-5c611ff1375d481296f28bff9aa5d3512023-11-19T12:22:13ZengBMCArthroplasty2524-79482023-09-015111110.1186/s42836-023-00200-8Standard versus short stem cemented Exeter® when used for primary total hip arthroplasty: a survivorship analysisNick D. Clement0Liam Z. Yapp1Leo D. Baxendale-Smith2Deborah MacDonald3Colin R. Howie4Paul Gaston5Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Little FranceEdinburgh Orthopaedics, Royal Infirmary of Edinburgh, Little FranceEdinburgh Orthopaedics, Royal Infirmary of Edinburgh, Little FranceDepartment of Orthopaedics, University of Edinburgh, Little FranceDepartment of Orthopaedics, University of Edinburgh, Little FranceEdinburgh Orthopaedics, Royal Infirmary of Edinburgh, Little FranceAbstract Aims The aims were to compare the survival of the cemented standard (150 mm) with the short (DDH [35.5 mm offset or less], number 1 short stem [125 mm options of 37.5 mm, 44 mm, 50 mm offset] and revision [44/00/125]) Exeter ® V40 femoral stems when used for primary total hip arthroplasty (THA). Methods Patients were retrospectively identified from an arthroplasty database. A total of 664 short stem Exeter ® variants were identified, of which 229 were DDH stems, 208 number 1 stems and 227 revision stems were implanted between 2011 and 2020. A control group of 698 standard Exeter ® stems used for THA was set up, and were followed up for a minimum of 10 years follow-up (implanted 2011). All-cause survival was assessed for THA and for the stem only. Adjusted analysis was undertaken for age, sex and ASA grade. Results The median survival time for the short stems varied according to design: DDH had a survival time of 6.7 years, number 1 stems 4.1 years, and revision stems 7.2 years. Subjects in the short stem group (n = 664) were significantly younger (mean difference 5.1, P < 0.001) and were more likely to be female (odds ratio 1.89, 95% CI 1.50 to 2.39, P < 0.001), compared to the standard group. There were no differences in THA (P = 0.26) or stem (P = 0.35) survival at 5 years (adjusted THA: 98.3% vs. 97.2%; stem 98.7% vs. 97.8%) or 10 years (adjusted THA 97.0% vs. 96.0 %; stem 96.7% vs. 96.2%) between standard and short stem groups, respectively. At 5 years no differences were found in THA (DDH: 96.7%, number 1 97.5%, revision 97.3%, standard 98.6%) or stem (DDH: 97.6%, number 1 99.0%, revision 97.3%, standard 98.2%) survival between/among the different short stems or when compared to the standard group. Conclusion The Exeter ® short stems offer equivocal survival when compared to the standard stem at 5- to 10-year follow-up, which does not seem to be influenced by the short stem design.https://doi.org/10.1186/s42836-023-00200-8Total hip arthroplastyCementedStemLengthShortOutcome |
| spellingShingle | Nick D. Clement Liam Z. Yapp Leo D. Baxendale-Smith Deborah MacDonald Colin R. Howie Paul Gaston Standard versus short stem cemented Exeter® when used for primary total hip arthroplasty: a survivorship analysis Arthroplasty Total hip arthroplasty Cemented Stem Length Short Outcome |
| title | Standard versus short stem cemented Exeter® when used for primary total hip arthroplasty: a survivorship analysis |
| title_full | Standard versus short stem cemented Exeter® when used for primary total hip arthroplasty: a survivorship analysis |
| title_fullStr | Standard versus short stem cemented Exeter® when used for primary total hip arthroplasty: a survivorship analysis |
| title_full_unstemmed | Standard versus short stem cemented Exeter® when used for primary total hip arthroplasty: a survivorship analysis |
| title_short | Standard versus short stem cemented Exeter® when used for primary total hip arthroplasty: a survivorship analysis |
| title_sort | standard versus short stem cemented exeter r when used for primary total hip arthroplasty a survivorship analysis |
| topic | Total hip arthroplasty Cemented Stem Length Short Outcome |
| url | https://doi.org/10.1186/s42836-023-00200-8 |
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