A 12 year survivorship study of the Exeter Universal cemented stem

• Huw Williams, FRACS, Bendigo, Australia
• Graham A. Gie, FRCS, Exeter, UK
• Robin S.M. Ling, FRCS, Exeter, UK
• A.J.Clive Lee, PhD, Exeter, UK
• A.John Timperley, FRCS, Exeter, UK

A survival analysis over a follow-up of twelve years of the first consecutive 325 Exeter universal cemented femoral components inserted at the Princess Elizabeth Orthopaedic Centre, Exeter has been published (J Bone Joint Surg Br  (England), Apr 2002, 84(3) p324-34 )

Materials and methods
The life-table method of survival analysis was used.  No case was lost to follow-up.  Survival analysis was performed with multiple endpoints.

Results
In the hands of surgeons of widely differing experience and up to 12 years follow-up,

• Survivorship with any operation as the end point is 92%, with 95% confidence limits of 87.7 to 95.8%.  

• Survivorship with revision of the femoral component for aseptic loosening as the end point is 100%, with 95% confidence limits of 98.0 to 100%.

• Survivorship with revision of the cemented acetabular component for aseptic loosening as the end point is 97%, with 95% confidence limits of 93.1 to 98.6%.

Conclusions
In this multi-surgeon series, the Exeter universal cemented femoral component has proved to function reliably with no case of stem loosening at 12 years. Radiologically the appearances were good with very few radiolucencies and excellent preservation of bone stock. Only one case of localised femoral osteolysis has emerged in this series to date.  These results are believed to hinge, at least in part, on the combination of the double-wedge taper stem geometry, completely devoid of any form of collar, and the highly polished stem surface finish.  The findings overall support the view that this femoral component functions as a taper in relation to the cement.