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Cemented exeter total hip arthroplasty with a 32 mm head on highly crosslinked polyethylene does age influence functional outcome, satisfaction, activity, stem migration, and periprosthetic bone mineral density?

Lookup NU author(s): Katie Merrie, Sherron Furtado, Professor David Deehan, David Langton

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Abstract

© 2019 Author(s) et al. This article distributed under the terms of the creative commons attribution-Non commercial 4.0 international (cc-by-Nc 4.0) licence (https://creativecommons.org/licences/by-nc/4.0/), which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed.Objectives our primary aim was to describe migration of the exeter stem with a 32 mm head on highly crosslinked polyethylene and whether this is influenced by age. our secondary aims were to assess functional outcome, satisfaction, activity, and bone mineral density (BMD) according to age. Patients and Methods A prospective cohort study was conducted. patients were recruited into three age groups: less than 65 years (n = 65), 65 to 74 years (n = 68), and 75 years and older (n = 67). There were 200 patients enrolled in the study, of whom 115 were female and 85 were male, with a mean age of 69.9 years (sd 9.5, 42 to 92). They were assessed preoperatively, and at three, 12 and, 24 months postoperatively. stem migration was assessed using einzel-Bild-Röntgen-Analyse (eBRA). Western Ontario and McMaster Universities osteoarthritis Index (WoMAc), Harris Hip score (HHs), Hip Disability and osteoarthritis outcome score (Hoos), euroQol-5 domains questionnaire (eQ-5D), short form-36 questionnaire (sF-36,) and patient satisfaction were used to assess outcome. The Lower extremity Activity scale (LeAs), Timed Up and Go (TUG) test, and activpAL monitor (energy expelled, time lying/standing/walking and step count) were used to assess activity. The BMD was assessed in Gruen and charnley zones. Results Mean varus/valgus tilt was -0.770 and axial subsidence was -1.20 mm. no significant difference was observed between age groups (p 0.07). There was no difference according to age group for postoperative WoMAc (p 0.11), HHs (p 0.06), Hoos (p 0.46), eQ-5D (p 0.38), patient satisfaction (p 0.05), or activpAL (p 0.06). patients 75 years and older had a worse sF-36 physical function (p = 0.01) and physical role (p = 0.03), LeAs score (p < 0.001), a shorter TUG (p = 0.01), and a lower BMD in charnley zone 1 (p = 0.02). Conclusion exeter stem migration is within normal limits and is not influenced by age group. Functional outcome, patient satisfaction, activity level, and periprosthetic BMD are similar across all age groups.


Publication metadata

Author(s): Clement ND, Bardgett M, Merrie K, Furtado S, Bowman R, Deehan DJ, Holland J, Langton DJ

Publication type: Article

Publication status: Published

Journal: Bone and Joint Research

Year: 2019

Volume: 8

Issue: 6

Pages: 275-287

Online publication date: 28/06/2019

Acceptance date: 02/04/2016

ISSN (electronic): 2046-3758

Publisher: British Editorial Society of Bone and Joint Surgery

URL: https://doi.org/10.1302/2046-3758.86.BJR-2018-0300.R1

DOI: 10.1302/2046-3758.86.BJR-2018-0300.R1


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