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Use of patient-specific templates in hip resurfacing arthroplasty: experience from sixteen cases

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Abstract

Purpose

Hip resurfacing arthroplasty (HRA) is a technically demanding operation, requiring both accuracy and precision in placement of the acetabular and femoral components. Malalignment of the component can lead to notching and possible femoral neck fractures. We used specific templates created using a rapid prototyping machine based on the patients’ anatomy, to aid in accurate intraoperative pin placement.

Methods

A 3D model of the hip was reconstructed using spiral computed tomography (CT) data by Amira 3.1 software in 16 patients in whom HRA was planned for hip osteoarthritis (OA). All of the patients in the study had normal contralateral hips. The rotational centre of femoral head on the normal side was superimposed using Imageware12.0 software to determine the centre of the femoral head on the contralateral side. The data was then used to produce patient-specific templates using a rapid prototyping technique. These templates were designed according to the anatomical features of femoral head surface, the rotation centre and the planned prosthesis shaft angle. The orientation of the prosthesis was determined by matching the model to the femoral head surface during the operation. In addition, a control group of 18 patients with OA was operated upon by the conventional method.

Results

The mean prosthesis stem shaft angle (SSA), as determined from postoperative imaging, was 138.68 ± 8.85° for the locating template group, and (118.9 ± 12.8) for the conventional group.

Conclusions

The locating template designed and constructed preoperatively can provide precise and dependable location for hip resurfacing femoral components during arthroplasty and ensure the valgus stem placement necessary for optimal outcomes.

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Authors and Affiliations

  1. Department of Orthopaedics, First Affiliated Hospital of Henan University of Science and Technology, JingHua road No. 24, Luoyang, 471003, China

    Hao Du, Tong-sen Li, Jin-sheng Yang & Ke-han Li

  2. Department of Gastroenterology, First Affiliated Hospital of Henan University of Science and Technology, JingHua road No. 24, Luoyang, 471003, China

    Xiao-xiao Tian

  3. Department of Orthopaedics, Xijing Hospital, the Fourth Military Medical University, Xi’an, 710033, China

    Guo-xian Pei

  4. National Die & Mold CAD Engineering Research Center, Shanghai Jiaotong University, Shanghai, 200030, China

    Le Xie

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  1. Hao Du
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  3. Tong-sen Li
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  4. Jin-sheng Yang
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Correspondence to Xiao-xiao Tian.

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Du, H., Tian, Xx., Li, Ts. et al. Use of patient-specific templates in hip resurfacing arthroplasty: experience from sixteen cases. International Orthopaedics (SICOT) 37, 777–782 (2013). https://doi.org/10.1007/s00264-013-1842-4

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  • DOI: https://doi.org/10.1007/s00264-013-1842-4

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