Abstract
Introduction
The Exeter Hip femoral component remains largely unchanged from the original design, introduced in 1970. It is a highly polished, modular, double tapered stem and has undergone various minor modifications to surface, modularity and most recently the taper; changed to the current V40TM design in 2000.
The effect of any design modification cannot easily be foreseen and greater emphasis is now placed on ensuring appropriate monitoring for such implants.
Methods
We present the results of the first 540 V40TM Exeter THAs performed in our Centre between December 2000 and May 2002. All patients were reviewed prospectively at 1, 5 and 10 years following surgery.
Results
Ten years after surgery there are no 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. One hundred and forty-five patients (26.9%) died before 10 years and of the remaining 395 stems, 374 (94.7%) remain in situ, 11 were revised (2.7%). Three were revised for infection, one for recurrent dislocation and one implant failed at the neck of the prosthesis. Ten were exchanged using cement-in-cement techniques to aid acetabular revision. There were ten periprosthetic fractures: six requiring stem revision, two underwent ORIF and two had already healed by the time the patients presented for follow-up. There was no radiographic evidence of failure preceding the periprosthetic fractures.
All radiographs and pain scores were analysed as part of long-term follow-up, and are discussed.
Discussion
There were no revisions for aseptic loosening. Previous studies from this centre reviewing the Original and Universal series have demonstrated the stem to provide a predictable and reproducible long term outcome with 100% survival well beyond10 years for aseptic loosening.
Conclusion
The polished V40TM Exeter stem continues to perform well and survival has remained comparable to the Universal series.
