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.