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The Exeter Universal hip in patients 50 years or younger at 10-17 years' followup
Simon C Lewthwaite1, Ben Squires, Graham A Gie
1Princess Elizabeth Orthopaedic Centre, Exeter, UK. slewthy@hotmail.com
Insights
The Exeter Universal hip replacement shows good survival rates in young patients, with 92.6% survivorship at 12.5 years. The femoral stem performed exceptionally well, indicating suitability for younger, active individuals.
Area of Science:
- Orthopedic surgery
- Biomaterials science
- Medical device engineering
Background:
- The Exeter Universal hip system has demonstrated high survival rates in general patient populations.
- However, its long-term performance in younger, more active individuals remains less understood.
- This demographic often places higher demands on prosthetic implants.
Purpose of the Study:
- To evaluate the survivorship and clinical outcomes of the Exeter Universal hip system in patients aged 50 years or younger.
- To assess radiographic evidence of loosening and other complications in this specific patient group.
- To determine the suitability of this implant for young, high-demand patients.
Main Methods:
- A retrospective review of 130 Exeter Universal hip systems implanted in 107 patients aged 50 or younger.
- Minimum follow-up of 10 years (mean 12.5 years) with no loss to follow-up.
- Analysis of revision rates, reasons for revision, and radiographic findings, including component loosening.
Main Results:
- Twelve hips (9.2%) required revision surgery.
- Aseptic loosening of the acetabular component was the most common reason for revision (9 hips).
- Overall survivorship for both stem and cup was 92.6% at 12.5 years; stem survivorship was 99%, with no stem revisions for aseptic loosening.
Conclusions:
- The Exeter Universal hip system demonstrates favorable survivorship and outcomes in young, high-demand patients.
- While acetabular component loosening occurred, the femoral stem exhibited excellent durability in this cohort.
- The implant appears to be a viable option for younger individuals undergoing hip replacement surgery.
Unlabelled:
The Exeter Universal hip (Stryker Inc., Newbury, UK) has reported survival rates of 91.74% at 12 years in all patients with reoperation as an endpoint. However, its performance in younger patients has not been fully established. We reviewed survivorship and the clinical and radiographic outcomes of this hip system implanted in 107 patients (130 hips) 50 years old or younger at the time of surgery. The mean age at surgery was 42 years. The minimum followup was 10 years (mean, 12.5 years; range, 10-17 years) with no patients lost to followup. Twelve hips had been revised. Of these, nine had aseptic loosening of the acetabular component and one cup was revised for focal lysis and pain. One hip was revised for recurrent dislocation and one joint underwent revision for infection. Radiographs demonstrated 14 (12.8%) of the remaining acetabular prostheses were loose but no femoral components were loose. Survivorship of both stem and cup from all causes was 92.6% at an average of 12.5 years. Survivorship of the stem from all causes was 99% and no stem was revised for aseptic loosening. The Exeter Universal stem performed well, even in the young, high-demand patient.
Level Of Evidence:
Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
