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The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve

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The concentric all-polyethylene Exeter acetabular component in primary total hip replacement.

S W Veitch¹, S L Whitehouse, J R Howell

¹Salisbury District Hospital, Odstock Road, Salisbury, Wiltshire SP2 8BJ, UK. swveitch@doctors.org.uk

The Journal of Bone and Joint Surgery. British Volume

|October 2, 2010

Summary

The cemented Exeter acetabular component shows excellent long-term survivorship in hip replacements. This all-polyethylene design demonstrates high success rates, even after 15 years, making it a reliable option.

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Area of Science:

Orthopedic Surgery
Biomaterials Science
Medical Device Technology

Background:

The Exeter acetabular component is a widely used cemented all-polyethylene prosthesis.
Long-term outcomes of this specific flangeless design require continued evaluation.

Purpose of the Study:

To assess the long-term clinical outcome and survivorship of the flangeless, cemented all-polyethylene Exeter acetabular component.
To evaluate radiographic findings including radiolucency and component migration.

Main Methods:

Retrospective review of 263 hips in 243 patients with a mean follow-up of 14.6 years.
Kaplan-Meier survivorship analysis with revision for any cause and aseptic loosening as endpoints.
Radiographic assessment of surviving components for radiolucency and migration.

Main Results:

At 15 years, Kaplan-Meier survivorship was 89.9% (revision for any cause) and 91.7% (aseptic loosening).
For primary osteoarthritis cases, survivorship was 93.2% (revision for any cause) and 95.0% (aseptic loosening).
Radiolucent lines were present in 49% of surviving hips; two components migrated without requiring revision.

Conclusions:

The flangeless, cemented all-polyethylene Exeter acetabular component demonstrates excellent long-term survivorship.
This prosthesis is a reliable option for hip replacement, particularly in primary osteoarthritis cases.
Radiographic findings like radiolucency do not always necessitate revision surgery.