Neck fracture of the exeter stem in 3 patients ncbi. A radiographic followup at minimum of five years post implantation. A single laboratory study in the literature has raised possible concerns about the polished finish of the ets and subsequent potential for accelerated loosening although there is. Use a proven femoral stem design exeter trauma stem ets proven stem design. Hip replacement surgery is a procedure in which a surgeon surgically removes a painful hip joint with arthritis and. The exeter trauma stem ets has been recommended by national institute of clinical excellence nice guidelines in the united kingdom as a proven, cemented stem. The exeter trauma stem is a new monoblock unipolar implant using an intermediate size 1. The exeter stem by stryker has become one of the most successful and widely used stems in modern cemented hip arthroplasty. Lora fleming director of european centre for environment and human health. A prospective study of hip revision surgery using the exeter. We described a previously unreported vancouver b12 fracture through the femoral stem implant post trauma with no signs of loosening. Fracture through a femoral stem prosthesis after trauma. Cemented hip replacement exeter stem and rim fit cup dr. In the seventh uk national joint registry report of 2010, the exeter v40 hip was the market leader, with 60% of the market.
Medium to long term follow up of a consecutive series of 604 exeter trauma stem hemiarthroplasties ets for the treatment of displaced intracapsular femoral neck fractures. The purpose of this study was to compare the cumulative incidence of postoperative periprosthetic fracture ppf in a cohort of femoral neck fracture fnf patients treated with two commonly used cemented stems. Exeter trauma stem versus thompson prosthesis for hip hemiarthroplasty. Neck cu t has been made 1cm above lesser trochanter with shoulder of prosthesis. Postoperative periprosthetic fractures in hip fracture patients. Cemented thompson hemiarthroplasty versus cemented exeter trauma stem ets hemiarthroplasty for intracapsular hip fractures. Dr pallavi amitava banerjee, from the university of exeters graduate school of education, used the national pupil database, government statistics about each school and pupil, to assess the impact of stem enrichment schemes on how well. The exeter cemented stem has excellent survivorship, reported as 100% at 17 years carrington et al, and is a polished, double tapered cemented stem which has an odep a star rating. Implants revision thr restoration modular reclaim modular corail revision. The exeter v40 stem stryker, newbury, uk is the most commonly inserted cemented stem in total hip arthroplasty in the united kingdom.
Hip replacement is a surgical procedure in which the hip joint is replaced by a prosthetic implant, that is, a hip prosthesis. Implants hemiarthroplasty uncemented corail stem synergy stem polarstem accolade medacta trilock bicontact excia summit. To our knowledge no cases of spontaneous stem failure with previous insufficiency fractures have yet been reported. Background the longstem exeter femoral component is commonly used in revision hip surgery. New hampshire trauma system participating hospitals june 20. Incidence of exeter stem fracture is extremely uncommon. We present a case of a rare stem fracture which was treated by cementincement revision arthroplasty technique. The year 2010 will see two major milestones for the exeter hip replacement stryker.
Conclusion we presented a rare case of a failed exeter femoral stem and pubic rami insuciency fracture in patient with previous hip arthroplasty. History, treatment and analysis of a rare form of exeter stem. Exeter health library, level 2 pmsrild building, royal devon and exeter nhs foundation trust, barrack road, exeter, devon, ex2 5dw. Polished tapered collarless femoral implants are in common use in primary hip arthroplasty. The surface finish differs from that of the exeter stem in that it has not been hand polished. Learn the exeter trauma stem for intracapsular neck of femur fracture stryker surgical technique with step by step instructions on orthoracle. The ets was first introduced on the market in 2002 and has been used in the authors institution since then. This should be used as a guide with the preoperative. The tritanium acetabular component is an uncemented shell with modular liner options and is 7a star rated by odep.
The 27th of november will be the 40th anniversary of the first exeter hip stem implant in a patient. Orthopaedic trauma teaching resource, including common classification systems and overview pages looking at all musculoskeletal injuries. Exeter trauma stem trilliance polarstem charnley cpt tridentexeter excia. Confirm that a cemented hemiarthroplasty is indicated. We report a fracture of such a stem in the absence of trauma 5 years after the revision procedure. To date there has been no comparison between the exeter trauma stem ets, which is a monoblock single size stem versus the joint replacement instrumentation jri, a modular cemented hip used in the treatment of intracapsular fracture neck of femur fractures. The exeter cemented femoral hip system is designed for surgeons that are looking to. In 1997, the princess elizabeth orthopaedic centre peoc at the royal devon and exeters wonford site opened and the old peoh site closed. The anatomic shape, the more distal anchoring of the stem, and the possibly favorable stem positioning of the sp2 stem might be the reasons for the lower risk of ppf in this fragile and highrisk population. The hollow centraliser should be used with the exeter stem because it provides a space below the stem tip, which pre vents endbearing of the stem and ensures that the proximal, expanded taper of the stem will engage properly in the cement mantle. A randomized controlled trial comparing the thompson. Increased risk for postoperative periprosthetic fracture in. July 2018 please bring this leaflet when you attend. Exeter stem, periprosthetic hip fracture, revision arthoplasty, stem fracture how to cite this article lyons rf, murphy cg.
Exeter vs anatomic sp2 lubinus stem ppfevl the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Postoperative periprosthetic fractures in hip fracture. The unit hosts surgeons in exeter for periods of observation and training. Cottage hospital alice peck day memorial new london hospital.
The exeter hip unit team are responsible for the innovative development of the exeter total hip replacement implant system and techniques for implantation and fixation in total hip replacement. This study prospectively evaluates the first 50 ets hemiarthroplasties performed as a primary treatment for fractured neck of femur at norfolk and norwich university hospital. Increased risk for postoperative periprosthetic fracture. Cemented hip replacement exeter stem and rim fit cup. Stem fixation as the double tapered, polished, collarless exeter stem engages, it becomes progressively more stable and secure within the cement mantle. The exeter trauma stem is a lowercost monobloc stem for hip hemiarthroplasty in the context of an intracapsular hip fracture. Exeter trauma stem hip hemiarthroplasty cambridge orthopaedics. Petheram tg, bone m, joyce tj, serranopedraza i, reed mr, partington pf. We offer marketleading hip replacement implants for total hip arthroplasty including our primary and revision portfolios designed to offer you a wide variety of implants, instrumentation and musclesparing surgical approach options. The exeter trauma stem ets is a double tapered polished stem stryker orthopaedics, mahwah. Exeter vs anatomic sp2 lubinus stem ppfevl the safety and scientific validity of this study is the responsibility of. A 67yearold male presented with pain in the left hip after a fall. The stem is commonly paired with the contemporary polyethylene socket.
Fracture of an exeter cement in cement revision stem. In this retrospective multicenter cohort study of a consecutive series of patients. Recent guidance recommends the use of a wellproven cemented femoral stem for hemiarthroplasty in the management of fractures of the femoral neck, and the exeter trauma stem ets has been. A randomised trial of 200 patients, injury on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips. New jersey based on the design of an exeter v40 stem. History, treatment and analysis of a rare form of exeter. Since 2006 a short exeter stem with 44mm offset has been available specifically for this purpose. Subsidence of the femoral stem in primary hip arthroplasty has been studied extensively, but much less is known about its signi. This study prospectively evaluates the first 50 ets hemiarthroplasties performed as a primary.
Although exeter stem failure is extremely uncommon, more patients are undergoing hip arthroplasty as our population continues to age, and so clinicians should be aware of potential. Full text fracture through a femoral stem prosthesis. Cemented thompson hemiarthroplasty versus cemented exeter. National hip fracture database nhfd facilities survey 2019.
The similarities between the ets and the exeter stem make this a straight forward process for even the less experienced surgeon and theatre team. Jun 01, 2012 read cemented thompson hemiarthroplasty versus cemented exeter trauma stem ets hemiarthroplasty for intracapsular hip fractures. Introduction the exeter trauma stem ets is a new monoblock unipolar prosthesis with no independent published series using this implant. Concord hospital catholic medical center va hospital. Our elearning platform contains high resolution images and a certified cme of the exeter trauma stem for. Exeter stem and pubic rami insufficiency fracture, following hybrid total hip arthroplasty inderpaul samra and christos paliobeis department of trauma and orthopaedics, hereford county hospital, wye valley nhs trust, hereford hr4 0ba, uk. In this retrospective multicenter cohort study of a consecutive series of patients, we included. Today, the centre continues to develop its reputation as. This report describes a case of spontaneous fracture through a cemented exeter stem in a 66yearold patient who. On the femoral side, a cemented exeter v40 stem was used offset 44 mm, size 2. Stem design the exeter stem utilises the inherent time dependent properties of bone cement to improve fixation, optimise load transmission and aids the restoration of normal patient anatomy. This prospective study examined the relationship between radiological subsidence, western. Evidence for the impact of mindfulness on children and.
This study prospectively evaluates the first 50 ets. Hip replacement surgery can be performed as a total. Cementincement revision with the exeter short revision stem. The exeter hip system celebrates 40 years and 1 million stems. Jan 18, 2011 the stem is commonly paired with the contemporary polyethylene socket. Patient information royal devon and exeter nhs foundation t rust your exeter primary hip replacement your exeter primary hip replacement reference number. It was postulated that the monoblock single size stem. The exeter cemented femoral hip system is designed for surgeons who are looking to utilise a single system for all hip indications, primary, fracture and revision, with a single proven system.
The stem centraliser is not retentive and when placed on the tip of the stem it may need to. Exeter stem, periprosthetic hip fracture, revision arthoplasty, stem fracture how to cite this. A recently published retrospective study by raut and parker 2015 found a ppf incidence of 1. Sep 28, 20 the exeter trauma stem is a lowercost monobloc stem for hip hemiarthroplasty in the context of an intracapsular hip fracture. The exeter trauma stem ets is a new monoblock unipolar prosthesis with no independent published series using this implant. Alternatives include the lowprofile polyethylene socket and the trident uncemented. Pubic rami insufficiency fractures following arthroplasty are also rare. The patient, an 87yearold man, presented with left hip pain and an inability to weight bear following a cracking sensation when he was standing to.
Alternatives include the lowprofile polyethylene socket and the trident uncemented socket. Highly crosslinked x3 sockets are becoming available. The exeter is a collarless stem, which allows for correction of leg length by adjusting the depth of stem insertion. Outcomes of 807 thompson hip hemiarthroplasty procedures and the effect of surgical approach on dislocation rates. The similarities between the ets and the exeter stem make this a straight forward process for even. Exeter trauma stem for intracapsular neck of femur. The team run several courses a year, teaching surgeons from. This report describes a case of spontaneous fracture through a cemented exeter stem in a 66yearold. The team run several courses a year, teaching surgeons from around the world. Thompsons hip hemiarthroplasty for neck of femur fracture. Substantially higher prevalence of postoperative peri. Cemented or uncemented hemiarthroplasty for femoral neck. The exeter cemented femoral hip system is designed for surgeons who are looking to utilise a single system for all hip indications, primary, fracture and revision. Evidence for the impact of mindfulness on children and young people katherine weare emeritus professor, universities.
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