Validation of patient specific surgical guides in total hip arthroplasty.

Abstract

The validation of patient-specific surgical guides (PSGs) by their design and the comparison of planned and actual PSG setting in total hip arthroplasty (THA) have not previously been reported. The errors between preoperative planning and computed tomography (CT)-based PSG setting (E1), and between preoperative planning and implantation (E2) were evaluated using CT in 16 fresh cadaveric hips. E2 was significantly smaller with the wide-base-contact resurfacing-THA PSG than with the narrow-base-contact type (P<0.05). E1/E2 of the wide-base-contact neck-cut PSG was 1.6±0.7°/2.4±1.1° for the coronal plane and 1.2±0.8 mm/0.7±0.5mm for the medial neck-cut height. E1/E2 of the wide-base-contact cup-impaction PSG was 1.0±0.9°/3.4±1.9° for inclination and 1.7±1.1°/6.6±4.4° for anteversion. The wide-base-contact PSG in resurfacing-THA and the PSG for neck-cut in THA could be applied clinically. Although cup-impaction PSG setting was acceptable, errors were made due to the impaction process during cup implantation.