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Outcomes of the Exeter V40 cemented femoral stem at a minimum of ten years in a non-designer centre

AIMS: The Exeter V40 cemented femoral stem was first introduced in 2000. The largest single-centre analysis of this implant to date was published in 2018 by Westerman et al. Excellent results were reported at a minimum of ten years for the first 540 cases performed at the designer centre in the Exet...

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Autores principales: Mahon, John, McCarthy, Cathal Jack, Sheridan, Gerard A., Cashman, James P., O'Byrne, John M., Kenny, Paddy
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The British Editorial Society of Bone & Joint Surgery 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7750737/
https://www.ncbi.nlm.nih.gov/pubmed/33367281
http://dx.doi.org/10.1302/2633-1462.112.BJO-2020-0163.R1
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author Mahon, John
McCarthy, Cathal Jack
Sheridan, Gerard A.
Cashman, James P.
O'Byrne, John M.
Kenny, Paddy
author_facet Mahon, John
McCarthy, Cathal Jack
Sheridan, Gerard A.
Cashman, James P.
O'Byrne, John M.
Kenny, Paddy
author_sort Mahon, John
collection PubMed
description AIMS: The Exeter V40 cemented femoral stem was first introduced in 2000. The largest single-centre analysis of this implant to date was published in 2018 by Westerman et al. Excellent results were reported at a minimum of ten years for the first 540 cases performed at the designer centre in the Exeter NHS Trust, with stem survivorship of 96.8%. The aim of this current study is to report long-term outcomes and survivorship for the Exeter V40 stem in a non-designer centre. METHODS: All patients undergoing primary total hip arthroplasty using the Exeter V40 femoral stem between 1 January 2005 and 31 January 2010 were eligible for inclusion. Data were collected prospectively, with routine follow-up at six to 12 months, two years, five years, and ten years. Functional outcomes were assessed using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores. Outcome measures included data on all components in situ beyond ten years, death occurring within ten years with components in situ, and all-cause revision surgery. RESULTS: A total of 829 stems in 745 patients were included in the dataset; 155 patients (20.8%) died within ten years, and of the remaining 664 stems, 648 stems (97.6%) remained in situ beyond ten years. For the 21 patients (2.5%) undergoing revision surgery, 16 femoral stems (1.9%) were revised and 18 acetabular components (2.2%) were revised. Indications for revision in order of decreasing frequency were infection (n = 6), pain (n = 6), aseptic component loosening (n = 3), periprosthetic fracture (n = 3), recurrent dislocation (n = 2), and noise production (ceramic-on-ceramic squeak) (n = 1). One patient was revised for aseptic stem loosening. The mean preoperative WOMAC score was 61 (SD 15.9) with a mean postoperative score of 20.4 (SD 19.3) (n = 732; 88.3%). CONCLUSION: The Exeter V40 cemented femoral stem demonstrates excellent functional outcomes and survival when used in a high volume non-designer centre. Outcomes are comparable to those of its serially validated predecessor, the Exeter Universal stem. Cite this article: Bone Jt Open 2020;1-12:743–748.
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spelling pubmed-77507372020-12-22 Outcomes of the Exeter V40 cemented femoral stem at a minimum of ten years in a non-designer centre Mahon, John McCarthy, Cathal Jack Sheridan, Gerard A. Cashman, James P. O'Byrne, John M. Kenny, Paddy Bone Jt Open Arthroplasty AIMS: The Exeter V40 cemented femoral stem was first introduced in 2000. The largest single-centre analysis of this implant to date was published in 2018 by Westerman et al. Excellent results were reported at a minimum of ten years for the first 540 cases performed at the designer centre in the Exeter NHS Trust, with stem survivorship of 96.8%. The aim of this current study is to report long-term outcomes and survivorship for the Exeter V40 stem in a non-designer centre. METHODS: All patients undergoing primary total hip arthroplasty using the Exeter V40 femoral stem between 1 January 2005 and 31 January 2010 were eligible for inclusion. Data were collected prospectively, with routine follow-up at six to 12 months, two years, five years, and ten years. Functional outcomes were assessed using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores. Outcome measures included data on all components in situ beyond ten years, death occurring within ten years with components in situ, and all-cause revision surgery. RESULTS: A total of 829 stems in 745 patients were included in the dataset; 155 patients (20.8%) died within ten years, and of the remaining 664 stems, 648 stems (97.6%) remained in situ beyond ten years. For the 21 patients (2.5%) undergoing revision surgery, 16 femoral stems (1.9%) were revised and 18 acetabular components (2.2%) were revised. Indications for revision in order of decreasing frequency were infection (n = 6), pain (n = 6), aseptic component loosening (n = 3), periprosthetic fracture (n = 3), recurrent dislocation (n = 2), and noise production (ceramic-on-ceramic squeak) (n = 1). One patient was revised for aseptic stem loosening. The mean preoperative WOMAC score was 61 (SD 15.9) with a mean postoperative score of 20.4 (SD 19.3) (n = 732; 88.3%). CONCLUSION: The Exeter V40 cemented femoral stem demonstrates excellent functional outcomes and survival when used in a high volume non-designer centre. Outcomes are comparable to those of its serially validated predecessor, the Exeter Universal stem. Cite this article: Bone Jt Open 2020;1-12:743–748. The British Editorial Society of Bone & Joint Surgery 2020-12-07 /pmc/articles/PMC7750737/ /pubmed/33367281 http://dx.doi.org/10.1302/2633-1462.112.BJO-2020-0163.R1 Text en © 2020 Author(s) et al. https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (CC BY-NC-ND 4.0) licence, which permits the copying and redistribution of the work only, and provided the original author and source are credited. See https://creativecommons.org/licenses/by-nc-nd/4.0/.
spellingShingle Arthroplasty
Mahon, John
McCarthy, Cathal Jack
Sheridan, Gerard A.
Cashman, James P.
O'Byrne, John M.
Kenny, Paddy
Outcomes of the Exeter V40 cemented femoral stem at a minimum of ten years in a non-designer centre
title Outcomes of the Exeter V40 cemented femoral stem at a minimum of ten years in a non-designer centre
title_full Outcomes of the Exeter V40 cemented femoral stem at a minimum of ten years in a non-designer centre
title_fullStr Outcomes of the Exeter V40 cemented femoral stem at a minimum of ten years in a non-designer centre
title_full_unstemmed Outcomes of the Exeter V40 cemented femoral stem at a minimum of ten years in a non-designer centre
title_short Outcomes of the Exeter V40 cemented femoral stem at a minimum of ten years in a non-designer centre
title_sort outcomes of the exeter v40 cemented femoral stem at a minimum of ten years in a non-designer centre
topic Arthroplasty
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7750737/
https://www.ncbi.nlm.nih.gov/pubmed/33367281
http://dx.doi.org/10.1302/2633-1462.112.BJO-2020-0163.R1
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