The Exeter Universal cemented femoral component at 15 to 17 years: an update on the first 325 hips.

The first 325 Exeter Universal stems (309 patients) implanted at the originating centre were inserted between March 1988 and February 1990 by a group of surgeons with differing experience. In this report we describe the clinical and radiological results at a mean of 15.7 years (14.7 to 17.3) after operation with no loss to follow-up. There were 97 patients (108 hips) with replacements still in situ and 31 (31 hips) who had undergone a further procedure. With an endpoint of revision for aseptic loosening, the survivorship at 17 years was 100% and 90.4% for the femoral and acetabular component, respectively. The mean Merle D'Aubigné and Postel scores at review were 5.4 (SD 0.97) for pain and 4.5 (SD 1.72) for function. The mean Oxford score was 38.4 (SD 9.8) (0 to 48 worst-to-best scale) and the mean combined Harris pain and function score was 73.2 (SD 16.9). Radiological review showed excellent preservation of bone stock in the proximal femur and no failures of the femoral component.

Percutaneous pulsed lavage for the infected knee replacement.

The low incidence of infection in knee arthroplasty is in sharp contrast to the high morbidity associated with its occurrence. This lends urgency to the need for early diagnosis and prompt management when infection does appear. To add to the armamentarium of the existing modalities in dealing with this condition, a new technique is described, which allows lavage at high pressure through a minimal access approach. It has been used successfully in two cases, though the follow-up was less than two years. A long-term follow-up will allow us to judge if this technique, used for the correct indications, can promote the longevity of the prosthesis threatened by infection.