Introduction: The Exeter Unipolar hemiarthroplasty is a variable-offset modular device. Implants which allow reconstruction of anatomical offset after hip fracture may allow early mobilisation after surgery. Objectives: This study aims compare the early results of the Exeter Unipolar (Exeter) with the Cemented Thompson (Thompson) hemiarthroplasty. Materiel/Patients and Methods: The Exeter Unipolar hemiarthroplasty is a variable-offset modular device. Implants which allow reconstruction of anatomical offset after hip fracture may allow early mobilisation after surgery. This retrospective cohort study included patients undergoing Thompson or Exeter hemiarthroplasty between November 2010 and August 2011. Choice of implant was made according to availability of equipment and surgeon preference. Groups were compared using thirteen descriptive variables to identify discrepancies in patient selection. Results were assessed using survival, complications and length of stay. Results: One hundred and seventeen patients underwent Thompsons (n = 67) or Exeter (n = 56) hemiarthroplasty by 24 different primary surgeons. Median followup was 9 months (6 - 11 months). Length of stay was lower in the Exeter group (Median 5.72 (4.01-7.95) vs 6.99 (4.58- 9.24) days P = 0.048). Time to discharge from rehabilitation was also lower in the Exeter group (Median 13.6 (11.0-23.8) vs 21.7 (16.0-31.2) days P = 0.0003) Three Thompson prostheses dislocated, there was one deep infection and one superficial wound infection. One Exeter prosthesis became infected requiring revision; there were no dislocations. Prosthesis survival at 1 year was similar between groups with 98.1% (SE 0.019) in the Exeter group and 95% (SE 0.027) in the Thompsons group. There were no statistically significant differences with respect to Age, Mental State, Co-morbidities, Mobility, Independence, Blood tests, Grade of Surgeon, Nottingham Hip Fracture Score or time to surgery. Conclusion: There was faster rehabilitation in the Modular Unipolar Exeter group. This could result from more accurate restoration of anatomical offset and ease of insertion compared to mono-block designs. The Unipolar Exeter Hemiarthroplasty reduces length of stay and improves rehabilitation after hip fracture, we recommend its use.
Lindisfarne, E. A. O., Dawe, E. J. C., & Stott, P. M. (2012). Unipolar modular exeter hemiarthroplasty reduces length of stay and allows faster rehabilitation after hip fracture: a retrospective study of 117 patients. Injury Extra, 43(10), 99. https://doi.org/10.1016/j.injury.2012.07.277