12:45

Total Hip replacement: Exeter femoral stem and Tritanium acetabular component (Stryker) surgical technique

Overview

Subscribe to get full access to this operation and the extensive Hip Surgery Atlas.

SUBSCRIBE


Learn the Total Hip replacement: Exeter femoral stem and Tritanium acetabular component (Stryker) surgical technique with step by step instructions on OrthOracle. Our e-learning platform contains high resolution images and a certified CME of the Total Hip replacement: Exeter femoral stem and Tritanium acetabular component (Stryker) surgical procedure.

The combination of a cemented stem and an uncemented cup is commonly know as a hybrid hip replacement due to the use of two fixation modes. The Stryker system allows for the use of ceramic or metal heads on either a ceramic or polyethylene liner. Ceramic on modern polyethylene has excellent survivorship and using a polyethylene liner allows for neutral or elevated acetabular options whereas a ceramic liner is only manufactured in a neutral version. Such elevated acetabular rim liners may be used to facilitate improved stability of the hip replacement.

The Exeter cemented stem has excellent survivorship, reported as 100% at 17 years (Carrington et al), and is a polished, double tapered cemented stem which has an ODEP* 13A star rating.

The Tritanium acetabular component is an uncemented shell with modular liner options and is 7A star rated by ODEP. It can be solid backed or cluster hole in design, allowing  additional screw fixation as desired.  The acetabular liner can be either ceramic or polyethylene, dual mobility and capture liner options also exist. The Tritanium cup has a highly porous titanium based surface which allows for high primary frictional stability immediately following implantation followed by bone ingrowth for biological fixation. Such a combination can be used in any aged patient, however consideration should also be given to a cemented cup in the more elderly patient.

The national joint database of England, Wales and Northern Ireland details excellent survivorship data on this ceramic on polyethylene combination.

 

The Exeter Universal cemented femoral component at 15 to 17 years. Carrington N, Sierra R, Gie G, Hubble M, Timperley A, Howell J. Journal of Bone and Joint Surgery, (2009); 91-B:730-7.

*ODEP – Orthopaedic data evaluation panel is a system where orthopaedic implants are rated on their survivorship by an expert panel. The number refers to the number of years of evidence and the letter the to the strength of the evidence provided. See http://www.odep.org.uk/Products.aspx for further information.

 

Author: Mr Richard Baker MD, MSc, MB.ChB, FRCS (Tr & Orth)

Institution : The Avon Orthopaedic Centre, Bristol, UK.

Author: Author: Mr Richard Baker MD, MSc, MB.ChB, FRCS (Tr & Orth).

Institution: Institution : The Avon Orthopaedic Centre, Bristol, UK.

Feedback

  • Each operation and the questions associated become named course in the CPD section
  • The operative technique itself is read as a lesson as is any company implant information if this is being assessed.
  • You’ll need to tick the box to confirm this has been done and can do this immediately if you have already read the op tech.
  • The vast majority of operations have a 10-15 MCQ quiz covering all aspects of the decision making and the technique
  • There are four possible answers of which one is correct (or on occasion more correct) than the others.
  • There are additional quiz modules on the surgical steps, the implants and problem cases being added continually
  • The course is completed once all the lessons are read and quizzes submitted and passed.
  • On successful completion of each quiz you will receive a validated certificate in your CPD folder.
  • Your dashboard also will contain a record of the time you have spent logged onto and using the site.
  • The timer suspends after 5 minutes though if there is no activity.
  • When you restart you will resume at the same point in the module.
  • Once you have completed each quiz you will need to feedback on the module first then click “submit” and your paper will be marked.
    The pass mark is 75%.
  • If you fall below this level you will be directed back to re-read the slides where you’ve tripped up.
  • Once these have been read you can re-do just the questions you failed on.
  • Once you have passed the quiz you can return at a future stage & resit .
Continue to Course Content

COURSE

Welcome to the Professional Development question section. The objective of taking these tests is to demonstrate that you have understood all aspects of the assessment and management of patients requiring surgical intevention. On successful completion you will receive a certificate accredited by both the Royal College of Surgeons of both England and Edinburgh as well as the British Orthopaedic Association.

Our content is designed for both Surgeons in independent practice and Surgeons in training.

COURSE PROGRESS

Lessons Status
QuizzesStatus

Accreditations

Logo Logo Logo Logo

Associates & Partners

Logo Logo Logo Logo Logo