Does using a modular variable offset hemiarthroplasty reduce length of stay after hip fracture? Early experience with the Exeter Unipolar hemiarthroplasty

Abstract

The Exeter Unipolar hemiarthroplasty is a variable offset modular device. We compared the early results of the Exeter Unipolar (Exeter) with the Cemented Thompson (Thompson) hemiarthroplasty in a retrospective cohort study. One hundred and twenty-three patients underwent Thompson (n = 68) or Exeter (n = 55) hemiarthroplasty by 24 different primary surgeons. Median follow-up was 9 months (interquartile range (IQR) 6–11, Range 3–13). Median length of stay was lower in the Exeter group 5.72 days (IQR 4.01–7.95, Range 2.7–33.7) vs 6.99 days (IQR 4.58–9.24, Range 1.2–59), p = 0.048. Median time to discharge from rehabilitation was also lower in the Exeter group (13.6 days (IQR 11.0–23.8, Range 5.8–59) vs 21.7 days (IQR 16.0–31.2, Range 1.2–86.3), 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. There were no statistically significant differences between groups in other factors studied. Power analysis suggested these differences should have been observed if present. Rehabilitation was faster in the Exeter group. This might result from more accurate restoration of femoral neck offset during surgery. The higher cost of the Exeter prosthesis is likely to be offset by the reduction in length of hospital stay. The Exeter Unipolar hemiarthroplasty reduces length of stay and hastens rehabilitation after hip fracture.