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[Modified Exeter technique in revision hip surgery].

E de Thomasson¹, O Guingand, R Terracher

¹Département Chirurgie-Orthopédique, Institut Mutualiste Montsouris, Paris, France. emmanuel.dethomasson@imm.fr

Revue De Chirurgie Orthopedique Et Reparatrice De L'Appareil Moteur

|June 17, 2008

Summary

This modified Exeter technique for hip revision surgery achieves primary stability by cementing the implant directly into bone, promoting allograft transformation and avoiding stress shielding. Mid-term results show excellent outcomes with no revisions for femoral loosening.

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Area of Science:

Orthopedic Surgery
Biomaterials Science
Bone Regeneration

Context:

Revision hip arthroplasty presents challenges with femoral bone stock loss.
The Exeter technique is known for addressing bone loss but can lead to implant migration.
Implant migration may compromise cement sheath integrity and lead to revision surgery.

Purpose:

To evaluate the mid-term outcomes of a modified Exeter technique for revision hip arthroplasty.
To assess the efficacy of directly cementing the distal implant into recipient bone for primary stability.
To analyze the long-term effects of this method on allograft incorporation and bone remodeling.

Summary:

A modified Exeter technique involving direct distal cementing achieved primary stability in 90% of 40 hips analyzed.

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Allograft transformation occurred in 36 cases, with corticalization in 14, and no cases of revision for femoral loosening were reported.

Clinical outcomes were good to excellent in 29 hips, with minimal implant migration in four cases requiring secondary stabilization.

Impact:

This technique offers a reproducible solution for femoral bone stock loss in revision hip arthroplasty.
It demonstrates successful allograft incorporation and bone remodeling without radiographic signs of stress shielding.
The findings suggest this modified approach provides durable, stable fixation comparable to the original technique.