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Migration pattern of cemented Exeter short stem in Dorr type A femurs. A prospective radiostereometry study with 2-year follow-up

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Introduction: The Exeter short stem (ESS) is 25 mm shorter than the standard length v40 Exeter stem (Stryker) and intended for a narrow femoral diaphysis. The purpose of the study was to evaluate the migration pattern of the cemented ESS. Material and method: In a prospective single-center cohort study, 23 patients (21 female) mean age 78 (range 70–89) with hip osteoarthritis and Dorr Type A femurs were included. Preoperative DXA was used to group patients into normal (> − 1) and low (< − 1) T-score. Components were the collarless polished double-tapered Exeter short stem type N°1 L125. Patients were followed for 2 years with model-based RSA (stem migration), regular hip radiographs (stem position and cementation quality), Oxford Hip Score (OHS) and VAS pain. Results: At 2-year follow-up, the stems subsided 1.48 mm (CI 95% 1.69; 1.26) and retroverted 0.45° (CI 95% 0.01; 0.88). From 12 to 24 months, stem subsidence was 0.18 mm (CI 95% 0.1; 0.25) (p = 0.001) and retroversion was − 0.04° (CI 95% − 0.27; 0.18) (p = 0.70). T-score and stem subsidence correlated (rho = 0.48; p = 0.025) and patients with normal T-score (n = 7) had 0.42 mm (CI 95% − 0.01; 0.85) less subsidence as compared to patients with low T-score (n = 15) (p = 0.054). Stems in varus position (n = 9) subsided 1.7 mm (CI 95% 1.35; 2.05) compared to 1.33 mm (CI 95% 1.05; 1.60) for stems in neutral position (n = 13) (p = 0.07). Postoperative cementation quality did not influence 2-year stem migration. OHS improved to 40.7 (CI 95% 36.8; 44.7) and VAS pain at rest and activity decreased to 5 mm and 10 mm, respectively (p < 0.001). Conclusion: The 2-year migration pattern of the cemented ESS was similar to reports for the cemented standard length Exeter stem. Low preoperative T-score and varus stem-position showed a tendency for higher stem migration and should be studied as risk factors for failure in larger studies of cemented polished stems.

Original languageEnglish
JournalArchives of Orthopaedic and Trauma Surgery
Pages (from-to)1071-1080
Number of pages10
Publication statusPublished - Feb 2023

Bibliographical note

Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

    Research areas

  • Bone cement, Hip arthroplasty, Radiostereometry, Stem migration, T-score

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