Acceptable long-term results after Boneloc hip arthroplasty

As the only femoral stem, the Exeter stem has shown acceptable results with Boneloc cement, but no long-term results have been published. The aim of this study was to evaluate the 20-year performance of Boneloc-cemented primary Exeter hip arthroplasty.

From March 1992 to June 1994, a total of 200 consecutive Boneloc-cemented primary hip arthroplasties were performed in 183 patients aged 26-90 years, mean 71 years. At follow-up after 18-20 years, the primary endpoint was prosthetic survival assessed by the Kaplan-Meier analysis. Secondary endpoints were clinical and radiographic follow-up examination.

After a mean 18.4 (17.6-19.6)-year period, 27 patients/32 hips had been revised. At endpoint revision for any reason the 20-year cumulative overall survival was 73% (95% confidence interval (CI): 49-89%); at endpoint revision for aseptic loosening the 20-year cumulative survival was 84% (95% CI: 68-96%) for the stem and 76% (95% CI: 61-92%) for the cup. Cementing technique, implant size and metal backing of the cup were not associated with revision rates. A total of 23 patients/24 hips had clinical/radiographic examination, and 10 patients/12 hips were assessed by telephone. According to patient reported evaluation, all were very satisfied or satisfied. Radiographs showed loosening of two cups and possible loosening of two stems.

This study provides the first long-term results on Boneloc-cemented primary hip arthroplasty. The Exeter prosthesis, especially the stem, maintains the previously published acceptable survival and results despite the documented inferior quality of the cement.

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