Authors
First Published in Sage Journals - Hip International, June 15, 2018
Abstract
Background:
The Exeter V40 Orthinox stem is one of the most commonly used femoral components in total hip arthroplasty. Its design, material and finish has evolved significantly from the original design established by Ling and Lee over 3 decades ago. An early problem reported with the original Exeter stem was a high rate of stem fractures. It was thought that with the new Orthinox steel used in the V40 system, the rate of stem fractures would reduce. There are reports of the Exeter V40 stem failing in a variety of locations.
Cases:
This paper highlights the 3 locations where the Exeter stem may fail and estimates a rate of 0.262% for stem fractures due to the constant use of the Exeter stem throughout the career of the senior surgeon.
Keywords:
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REFERENCES
1.Fowler, J, Gie, G, Lee, A. Experience with the Exeter total hip replacement since 1970. Orthop Clin North Am 1988; 19: 477–489.
Google Scholar | Medline | ISI
2.Davies, B, Branford White, H, Temple, A. A series of four fractured Exeter™ stems in hip arthroplasty. Ann R Coll Surg Engl 2013; 95: e130–e132.
3.Doorn, WJ, Biezen, FCV, Prendergast, PJ. Fracture of an Exeter stem 3 years after impaction allografting–a case report. Acta Orthop Scand 2002; 73: 111–113.
4.Hamlin, K, MacEachern, CF. Fracture of an Exeter stem: a case report. JBJS Case Connect 2014; 4: e66–e3.
5.Røkkum, M, Bye, K, Hetland, KR. Stem fracture with the Exeter prosthesis. 3 of 27 hips followed for 10 years. Acta Orthop Scand 1995; 66: 435–439.
6.Yates, PJ, Quraishi, NA, Kop, A. Fractures of modern high nitrogen stainless steel cemented stems: cause, mechanism, and avoidance in 14 cases. J Arthroplasty 2008; 23: 188–196.
7.Swarts, E, Kop, A, Jones, N. Microstructural features in fractured high nitrogen stainless steel hip prostheses: a retrieval study of polished, tapered femoral stems. J Biomed Mater Res A 2008; 84: 753–760.
8.Akinola, B, Mahmud, T, DeRoeck, N. Fracture of an Exeter stem-a case report. The Internet Journal of Orthopedic Surgery 2009; 16.
9.Reito, A, Eskelinen, A, Pajamäki, J. Neck fracture of the Exeter stem in 3 patients: a cause for concern? Acta Orthop 2016; 87: 193–196.
10.O’Neill, GK, Maheshwari, R, Willis, C. Fracture of an Exeter ‘cement in cement’ revision stem: a case report. Hip Int 2011; 21: 627–679.
11.Facek, M, Khatib, Y, Swarts, E. Prosthetic fracture of a cemented Exeter femoral stem (case report). Reconstructive Review 2016; 6.
12.Bergmann, G, Deuretzbacher, G, Heller, M. Hip contact forces and gait patterns from routine activities. J Biomech 2001; 34: 859–871.
Google Scholar | Medline | ISI