AB126. Outcomes of the Exeter v40 cemented femoral stem at a minimum of 10 years follow-up in a non-designer centre

Background: The Stryker Exeter V40 cemented femoral stem was first introduced in 2000. The largest analysis of this implant conducted so far was published in 2018 by Westermann et al. with a minimum 10-year follow-up of the first 540 cases performed in the designer centre in the Exeter NHS Trust, and demonstrated excellent long term survival. The aim of this study is to report long term outcomes and survivorship for the Exeter V40 stem from a non-designer centre.

Methods: All patients undergoing primary total hip arthroplasty using the Exeter V40 femoral stem between 01/01/2005 and 31/12/2009 were eligible for inclusion in this study. Data was collected prospectively, with routine follow-up at 1, 2, 5 and 10 years as per joint registry protocol in our institution. Data was then reviewed retrospectively between July 2019 and January 2020. Endpoints were defined as components in situ beyond 10/12/14 years, death occurring before 10/12/14 years with components in situ, and revision or component revision surgery.

Results: A total of 783 patients were included in the data set. Among these, 766 (97.8%) patients did not undergo revision surgery within the follow-up period; 621 (79.3%) were in situ beyond 10 years, and 145 (18.5%) were in situ at death before 10 years. Seventeen (2.2%) patients underwent revision surgery. Stem offset ranged from 30 to 50 mm with a mode of 44 mm. Head size ranged from 22.2 to 36 mm with a mode of 32 mm. Head materials predominantly consisted of Orthinox stainless steel, Alumina ceramic, and mixed oxide ceramic.

Conclusions: The Exeter V40 cemented femoral stem demonstrates excellent survival when used in a high volume non-designer centre. Outcomes are comparable to those of its serially validated predecessor, the Exeter Universal Stem.

Keywords: Arthroplasty; total hip arthroplasty; total hip replacement; cement; poly methyl methacrylate; exeter V40 stem