A custom-made guide for femoral component positioning in hip resurfacing arthroplasty: development and validation study

Abstract

In the field of hip resurfacing arthroplasty, accurate femoral component placement is important to achieving a positive outcome and implant survival in both the short and long term. In this study, femoral component placement was defined preoperatively using virtual computed tomography-based surgical simulation of a classical posterior surgical approach. Custom-made surgical drill guides were produced to reproduce the surgical plan in the operating room. We first developed a custom-made guide for guide-wire placement to position the femoral resurfacing component. Then, to assess the accuracy in vivo, the custom-made guide was evaluated in five patients with normal anatomy. The first hypothesis of this patient study was that the use of custom-made neck guides would allow for an average accuracy within the range of ± 4° for the drill path and ± 4 mm for the entry point of the guide-wire. A second hypothesis was that three-dimensional preoperative planning would enable the prediction of an implant size differing by a maximum of one size from the size eventually implanted. The presented hip resurfacing guide performed well in terms of fit, stability and accuracy. The in vivo accuracy study revealed an accuracy of 4.05 ± 1.84° for the drill path and 2.73 ± 1.97 mm for the entry point of the guide-wire. The predicted component sizes and the implanted component sizes differed maximally by one size, confirming our hypothesis. We conclude that these preliminary data are promising, but require further validation in a full clinical setting in larger patient groups.

3D-printed navigation template in proximal femoral osteotomy for older children with developmental dysplasia of the hip

“…Reverse modeling and RP technologies are widely used both at home and abroad to produce 3D-printed surgical navigation templates10111213. However, there have been no reports of their use in the treatment of older children with DDH.…”

The Evolution of Computer-Assisted Total Hip Arthroplasty and Relevant Applications

“…PST uses preoperative 3D images and has been applied to acetabular cup placement guide in THA and femoral guide wire insertion for hip resurfacing6061626364). However, it requires preoperative CT evaluation, a higher expense of producing the template and skill for optimal and precise preoperative planning.…”

“…10), various clinical studies are being carried out to verify the effectiveness and safety of these devices606162636465).…”

Customized Guide for Femoral Component Positioning in Hip Resurfacing Arthroplasty

“…Although several patient-specific guides (PSG) have been proposed in the literature and demonstrated utility with good accuracy, 10 - 14 few studies state the method for defining true FNA 11 14 To our knowledge, the best-known technique was developed by Mahaisavariya et al, 15 who established a method for geometrical assessment of the proximal femur in three dimensions.…”