Abstract
INTRODUCTION
Uncemented total hip replacement is on the rise worldwide. Latest studies from various European and other developed country joint registers are clearly showing that it is taking preference over the cemented joint replacements. These figures were discussed most recently at the London hip meeting. Our study is related to one single make of implant the Exceed hip (Biomet) at two hospitals in Northamptonshire, Kettering UK.
MATERIAL & METHODS
Our series includes 256 cases of Exceed uncemented total hip replacement done in 236 patients with a minimum follow up of 6 months and maximum of 5 years. The study included 126 female and 110 male patients. Out of this number 121 cases were done at Kettering General Hospital and 135 cases were performed at Woodlands Hospital private limited in Kettering. The cases were performed by 2 senior consultants and one junior consultant. The total number of cases was 317 but 73 cases were lost to follow up and 2 patients had expired at the time of the study. In all cases pre operative and post operative Harris hip scores were measured. Patients were asked to fill up the scores in retrospect through post. The range of motion parameter and range of motion scale were measured and added from clinical notes. The average age of patients in our study was 71.2 years with the oldest patient being 90 years old and the youngest being 34 years old. Most common cause for replacement was primary osteoarthritis in 202 cases. In 52 cases it was done for secondary osteoarthritis due to rheumatoid arthritis or post traumatic osteoarthritis following dislocation and acetabular fractures. In 2 cases it was done for fracture neck of femur. All the cases were done through posterior approach. One senior surgeon used bone grafts in the acetabular floor harvested from the femoral head at time of surgery in all of his cases. The ABT ringloc shell, polyethylene liner was used in all cases.
The average pre operative Harris hip score was 43.15 and average post operative Harris hip score was 78.32. In 4 cases peri prosthetic fractures occurred per operatively and needed fixation. In 3 cases dislocation occurred but only one case needed revision due to recurrent dislocation.
DISCUSSION
Our early results are showing encouraging results with the Exceed uncemented total hip replacement prosthesis. The Harris hip score post operatively shows good improvement and satisfaction. In two cases there was unexplained pain along the thigh and groin. One of these cases was post dislocation. The dislocation rate was around 1.2% and periprosthetic fracture rate was 1.6%. Longer follow up is needed to evaluate and compare the results of this particular implant with the other studies on uncemented total hip replacement that have been published in literature.
