The Custom Femoral Component is an Effective Option for Congenital Hip Dysplasia
- 1 October 2006
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Clinical Orthopaedics and Related Research
- Vol. 451, 146-153
- https://doi.org/10.1097/01.blo.0000224061.62861.0d
Abstract
Although custom-designed femoral prostheses seem more likely to be successful than off-the-shelf components for treatment of patients with osteoarthritis secondary to congenital hip dysplasia, published short-term results of custom stems with a smooth surface or titanium proximal mesh pads are no better than results for off-the-shelf components. To determine whether cementless custom femoral components with sandblasted surfaces provide better results than other custom stems, we prospectively evaluated 77 consecutive patients (99 hips) with a mean age of 54 years who had osteo-arthritis secondary to congenital hip dysplasia. The mean followup was 9 years 3 months. Forty-seven hips were classified as having Crowe Type I deformity, 41 were classified as having Crowe Type II deformity, and 11 were classified as having Crowe Type III deformity. The average Harris hip score was 97.6 points at the last followup. Radiographically, 88 hips (89%) showed bone ongrowth, seven hips (7%) showed stable fibrous fixation, and four hips (4%) showed unstable fixation. There were two intraoperative femoral fractures and varus malpositioning of four stems in the hips with stable fibrous fixation and the unstable hips. One femoral component was revised 6 years postoperatively. Although the anatomic cementless custom-designed femoral components with sandblasted surfaces provided favorable results in patients with Crowe Types I, II, and III deformities, intra-operative technical errors prevented bone ongrowth fixation.Keywords
This publication has 28 references indexed in Scilit:
- Three-dimensional Computed Cementless Custom Femoral Stems in Young PatientsClinical Orthopaedics and Related Research, 2005
- Femoral Deformity in Adults With Developmental Hip DysplasiaClinical Orthopaedics and Related Research, 1996
- Ingrowth SurfacesClinical Orthopaedics and Related Research, 1994
- The Case for Porous-Coated Hip ImplantsClinical Orthopaedics and Related Research, 1990
- The Various Stress Patterns of Press-Fit, Ingrown, and Cemented Femoral StemsClinical Orthopaedics and Related Research, 1990
- A New System to Produce Intraoperatively Custom Femoral Prosthesis From Measurements Taken During the Surgical ProcedureClinical Orthopaedics and Related Research, 1989
- Shape the Implant to the PatientClinical Orthopaedics and Related Research, 1989
- The Anatomic Basis of Femoral Component DesignClinical Orthopaedics and Related Research, 1988
- The Influence of Stem Size and Extent of Porous Coating on Femoral Bone Resorption after Primary Cementless Hip ArthroplastyClinical Orthopaedics and Related Research, 1988
- Modular Noncernented Total Hip Arthroplasty for Congenital Dislocation of the HipClinical Orthopaedics and Related Research, 1988