Introduction: As the only femoral stem, the Exeter stem has shown acceptable results with Boneloc cement, but no long-term results have been published. The aim of this study was to evaluate the 20-year performance of Boneloc-cemented primary Exeter hip arthroplasty.
Material and methods: From March 1992 to June 1994, a total of 200 consecutive Boneloc-cemented primary hip arthroplasties were performed in 183 patients aged 26-90 years, mean 71 years. At follow-up after 18-20 years, the primary endpoint was prosthetic survival assessed by the Kaplan-Meier analysis. Secondary endpoints were clinical and radiographic follow-up examination.
Results: After a mean 18.4 (17.6-19.6)-year period, 27 patients/32 hips had been revised. At endpoint revision for any reason the 20-year cumulative overall survival was 73% (95% confidence interval (CI): 49-89%); at endpoint revision for aseptic loosening the 20-year cumulative survival was 84% (95% CI: 68-96%) for the stem and 76% (95% CI: 61-92%) for the cup. Cementing technique, implant size and metal backing of the cup were not associated with revision rates. A total of 23 patients/24 hips had clinical/radiographic examination, and 10 patients/12 hips were assessed by telephone. According to patient reported evaluation, all were very satisfied or satisfied. Radiographs showed loosening of two cups and possible loosening of two stems.
Conclusion: This study provides the first long-term results on Boneloc-cemented primary hip arthroplasty. The Exeter prosthesis, especially the stem, maintains the previously published acceptable survival and results despite the documented inferior quality of the cement.
Funding: not relevant.
Trial registration: not relevant.