Experience with primary exeter total hip arthroplasty in patients with small femurs - Review at average follow-up period of 6 years

One hundred twelve hips in 101 Chinese patients received a primary cemented Exeter total hip arthroplasty (Howmedica, Hong Kong). Average age was 65 years. The most common diagnosis was avascular necrosis. Average follow-up period was 6 years (range, 3 years to 9 years, 6 months). The Harris hip score improved from a preoperative average of 41.2 to 82.2 at the last follow-up visit. Stem subsidence within the cement mantle occurred in 9% of the cases, and none of these stems had other evidence of loosening. Three hips in two patients were revised because of loosening at 5 to 8 years after surgery. Because of the small size of the femurs, stem oversizing was common. Oversizing of the stem and an incomplete cement mantle might account for the early loosening. Stems of a smaller size should be made available to this population.