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Surface finish of the Exeter Trauma Stem: A cause for concern?

Lookup NU author(s): Dr Martin Bone, Professor Tom Joyce, Gladys -, Michael Reed

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Abstract

Recent guidance recommends the use of a well-proven cemented femoral stem for hemiarthroplasty in the management of fractures of the femoral neck, and the Exeter Trauma Stem (ETS) has been suggested as an example of such an implant. The design of this stem was based on the well-proven Exeter Total Hip Replacement stem (ETHRS). This study assessed the surface finish of the ETS in comparison with the ETHRS. Two ETSs and two ETHRSs were examined using a profilometer with a precision of 1 nm and compared with an explanted Exeter Matt stem. The mean roughness average (RA) of the ETSs was approximately ten times higher than that of the ETHRSs (0.235 μm (0.095 to 0.452) versus 0.025 μm (0.011 to 0.059); p < 0.001). The historical Exeter Matt stem roughness measured a mean RA of 0.973 μm (0.658 to 1.159). The change of the polished Exeter stem to a matt surface finish in 1976 resulted in a high stem failure rate. We do not yet know whether the surface differences between ETS and ETHRS will be clinically significant. We propose the inclusion of hemiarthroplasty stems in national joint registries.

Publication metadata

Author(s): Petheram TG, Bone M, Joyce TJ, Serrano-Pedraza I, Reed MR, Partington PF

Publication type: Article

Publication status: Published

Journal: The Bone & Joint Journal

Year: 2013

Volume: 95-B

Issue: 2

Pages: 173-176

Print publication date: 01/02/2013

ISSN (electronic): 2044-5377

Publisher: British Editorial Society of Bone and Joint Surgery

URL: http://dx.doi.org/10.1302/0301-620X.95B1.31001

DOI: 10.1302/0301-620X.95B1.31001

PubMed id: 23365024

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