Aim. The aim of this study was to determine the medium term survivorship and function of the Exeter Universal Hip Replacement when used in younger patients, a group that is deemed to place high demands on their arthroplasties. Since 1988 The Exeter Hip Research Unit has prospectively gathered data on all patients who have had total hip replacements at the Princess Elizabeth Orthopaedic Hospital. There were 130 Exeter Universal total hip replacements (THR) in 107 patients who were 50 years or younger at the time of surgery and whose surgery was performed at least 10 years before. Mean age at surgery was 42 years (range 17-50 years.) Six patients who had 7 THRs had died, leaving 123 THRs for review. Patients were reviewed at an average of 12.5 years (range 10-17 years). No patient was lost to follow-up. Results. At review, 12 hips had been revised. Of these, 9 were for aseptic loosening of the acetabular component and one cup was revised for focal lysis and pain. One hip was revised for recurrent dislocation. One femoral component required revision in 1 case of infection. Radiographs showed that a further 11 (10%) of the remaining acetabular prostheses were loose but that no femoral components were loose. Survivorship of stem and cup from all causes was 94%, at an average of 12.5 years. Survivorship of stem only from all causes was 99% and from aseptic loosening was 100%. Conclusion. The Exeter Universal Stem is shown to perform extremely well in the younger patient. No femoral component became loose and only 9 acetabular components were revised for aseptic loosening

Aims

This study aimed to identify patients receiving total hip arthroplasty (THA) for trauma during the peak of the COVID-19 pandemic in the UK and quantify the risks of contracting SARS-CoV-2 virus, the proportion of patients requiring treatment in an intensive care unit (ICU), and rate of complications including mortality.

The cement in cement technique for revision total hip arthroplasty (THA) has shown good results in selected cases. However, results of its use in the revision of hemiarthroplasty to THA has not been previously reported. Between May 1994 and May 2007 28 (20 Thompson's and 8 Exeter bipolar) hip hemiarthroplasties were revised to THA in 28 patients using the cement in cement technique. All had an Exeter stem inserted at the time of revision. Clinical and operative data were collected prospectively. Clinical evaluation was by the Charnley, Harris and Oxford. Hip scores and radiographs were analysed post-operatively and at latest follow up. The mean age at time of hemiarthroplasty revision was 80 (35 to 93) years. The reason for revision was acetabular erosion in 12 (43%), recurrent dislocation in eight (29%), aseptic stem loosening in four (14%), periprosthetic fracture in two (7%) and infection in a further two (7%) patients. No patient has been lost to follow up. Three patients died within three months of surgery. The mean follow up of the remainder was 50 (16 to 119) months. Survivorship with revision of the femoral stem for aseptic loosening as the endpoint was 100%. Three cases (11%) have since undergone further revision, one for recurrent dislocation, one for infection, and one for periprosthetic fracture. The cement in cement technique can be successfully applied to revision of hip hemiarthroplasty to THA. It has a number of advantages in this elderly population including minimising bone loss, blood loss and operative time

Purpose. We describe an update of our experience with the implantation of the first 325 Exeter Universal hips. The fate of every implant is known. Methods and results. The first 325 Exeter Universal stems (309 patients) were inserted between March 1988 and February 1990. The procedures were undertaken by surgeons of widely differing experience. Clinical and radiological review was performed at a mean of 15.7 years. At last review 185 patients had died (191 hips). 103 hips remain in situ. Survivorship at 17 years with revision for femoral component aseptic loosening was 100% (95% CI 97 to 100), with revision for acetabular component aseptic loosening was 90.4% (95% CI 83.1 to 94.7) and with any re-operation as the endpoint was 81.1% (95% CI 72.5 to 89.7). 12 patients (12 hips) were not able to attend for review due to infirmity or emigration, and scores were obtained by phone (x-rays were obtained in 4 patients). Mean D'Aubigné and Postel scores (Charnley modification) at review were 5.4 for pain and 4.8 for function. The mean Oxford score was 21.6 +/− 9.8 and the mean Harris score 71.7 +/− 19.7. On radiological review there were no femoral component failures. Three sockets (2.9%) were loose as demonstrated by migration or change in orientation (two patients were asymptomatic) and 5 sockets (4.9%) had radiolucent lines in all 3 zones but no migration. There are two patients awaiting socket revision. Conclusion. The high rate of clinical and radiological success of the Exeter Universal stem seen at 12 years is sustained at 17 years. Further cup failures have occurred but overall survivorship remains good. With the favourable long-term behaviour of the original Exeter stem, we feel optimistic that good function of the Universal stem will continue through the third decade

Introduction. Surgical experience has been shown to improve the clinical outcomes in Total hip arthroplasty. The objective of this study was to compare clinical and radiological outcomes between Consultants and NCHDs grade surgeons for the Exeter total hip replacement taken from the Cappagh National Orthopaedic Hospital Joint Register. Methods & Materials. Between 2005 and 2008, 2749 primary total hip replacements were done, 433(15.78%) were Exeter total hip system. 380(86%) out of 433 were included in the study, 227(59%) were females and 154(41%) were males. A consultant was the primary surgeon for 193(51%) patients and an NCHD was the primary surgeon for 187(49%) patients. Mean age, at time of operation was 68 years. Clinical outcome was assessed with WOMAC and SF36 scoring system. Patients were invited to fill in the WOMAC and SF36 questionnaire, pre-operatively, at 6 months and at 2 years after the operation. Radiographs were evaluated for radiolucency with a standardized technique. Results. Mean WOMAC scores for consultant grade surgeons were: 61(pre op), 23.34(6 months post op) and 22.96(at 2 years post op) with standard deviations of 15.61(pre-op), 17.9(at 6 months) and 17.19(at 2 years). Average SF36 scores were 42.40(pre-op), 70.15(at 6 months) and 71.30(at 2 years) with standard deviations of 17.94(pre op), 18.02(6 months) and 22.59(2 years). NCHD grade surgeons had average WOMAC scores: 62.55(pre op), 22.36(6 months) and 25.35(2 years). Average SF36 scores were: 41.1(pre-op), 67.47(6 months) and 66.63(2 years). The difference in the mean WOMAC scores between consultants grade and NCHD grade surgeons were 1.55(pre-op), 0.98(6months) and 2.39(2 years), while the difference between the mean SF36 were 1.3(pre-op), 2.68(6 months) and 4.67(2 years). Student T Test was used to correlate differences between the 2 groups. The difference in outcomes between the 2 groups was not significant (P<0.05). Conclusion. We found out that both groups had similar outcome and survival, with no significant difference when using an Exeter Total Hip Arthroplasty