Abstract
ABSTRACTObjective: To prove the accuracy of a customized guide developed according to our method. Methods:This customized guide was developed from a three-dimensional model of proximal femur reconstructed using computed tomography data. Based on the new technique, the position of the guide pin insertion was selected and adjusted using the reference of the anatomical femoral neck axis. The customized guide consists of a hemispheric covering designed to fit the posterior part of the femoral neck. The performance of the customized guide was tested in eight patients scheduled for total hip arthroplasty. The stability of the customized guide was assessed by orthopedic surgeons. An intraoperative image intensifier was used to assess the accuracy. Results: The customized guide was stabilized with full contact and was fixed in place in all patients. The mean angular deviations in relation to the what was planned in anteroposterior and lateral hip radiographs were 0.5º ± 1.8º in valgus and 1.0º ± 2.4º in retroversion, respectively. Conclusion: From this pilot test, the authors suggest that the proposed technique could be applied as a customized guide to the positioning device for hip resurfacing arthroplasty with acceptable accuracy and user-friendly interface. Level of Evidence IV, Cases Series.
Highlights
Hip resurfacing arthroplasty (HRA) is an alternative to total hip arthroplasty (THA)
The patient-specific guides (PSG) was stabilized with full contact and was unmovable in all patients
In order to demonstrate the accuracy of femoral neck axis (FNA) determined through the PSG, we assessed the position during surgery and the angles measured in the AP and lateral views
Summary
Hip resurfacing arthroplasty (HRA) is an alternative to total hip arthroplasty (THA). The advantages of this procedure include preservation of the femoral bone stock,[1] minimized dislocation rate,[2] and improved range of motion.[3] HRA is a technically demanding procedure and femoral neck fracture has been documented as the most common cause of early failure.[4] This complication is related to varus malposition of the femoral component and superior notching of femoral neck.[5,6] Accurate positioning of the femoral component has been reported in association with successful long-term outcomes.[7] Optimal alignment traditionally is achieved using manual devices, and accuracy relies largely on visual inspection and the surgeon’s experience.
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