Exeter total hip arthroplasty with matte or polished stems

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Medical Imaging

Background:

• Total hip arthroplasty (THA) is a common procedure to address hip joint degeneration.
• The choice of femoral stem design, specifically surface finish (matte vs. polished), may influence long-term implant performance.
• Synovitis and joint effusion can be indicators of complications such as implant loosening.

Purpose of the Study:

• To compare implant survival rates between Exeter matte and polished stems in primary total hip arthroplasty.
• To investigate the association between synovitis/joint effusion and signs of implant loosening, considering stem type.

Main Methods:

• Retrospective analysis of revision rates for 118 primary hip replacements using Exeter matte (n=47) or polished (n=71) stems.
• Prospective evaluation of 24 patients (11 polished, 13 matte) using radiography and sonography to assess capsular distension.
• Sonography measured the distance between the femoral neck and anterior capsule to quantify capsular distension, indicative of synovitis.

Main Results:

• Implant survival at 13 years postoperatively was 78% for matte stems and 61% for polished stems (P=0.27).
• Stem survival rates were 82% for matte and 88% for polished stems (P=0.54).
• A significant relationship was found between increased capsular distension and cup loosening (P=0.04), but no significant difference in capsular distension was observed between matte and polished stems.

Conclusions:

• There was no statistically significant difference in overall implant survival rates between Exeter matte and polished stems.
• Increased capsular distension, a sonographic marker for synovitis, is significantly associated with cup loosening in total hip arthroplasty.
• Stem surface type did not significantly impact capsular distension.