Custom-design implants for severe distorted proximal anatomy of the femur in young adults followed for 4–8 years

Abstract

Background Treatment of hips with abnormal anatomy is challenging, and requires demanding surgical technique. We report the preoperative planning and the functional outcome of 38 patients with severe distorted anatomy who were treated with custom implants.

Patients and methods 38 consecutive patients (48 hips) were selected for customized femoral implants. The diagnosis was arthrosis due to congenital dislocation of the hip (CDH). We used plain radiographs, CT, and CAD-CAM analysis. The mean age was 47 (22–69) years and the mean preoperative D'Aubigne score was 10 (6–12). The mean follow-up time was 6 (4–8) years.

Results All implants had optimal fit and fill. There were 2 revisions due to infection. No patients had thigh pain and no patients had aseptic loosening. There were 5 intraoperative and 6 postoperative complications. The mean postoperative D'Aubigne score was 17 (10–18).

Interpretation Preoperative planning with modern technology and customized implants makes the procedure accurate, easier for the surgeon, and safer for the patient.

Contributions of authors

PK: main author of the manuscript, which was also his thesis. KS: collected the data. TS: reviewed the manuscript and made corrections to the paper. TX: the senior surgeon for these patients, and also reviewed the manuscript.