Document Detail

Shape the implant to the patient. A rationale for the use of custom-fit cementless total hip implants.
MedLine Citation:
PMID:  2582679     Owner:  NLM     Status:  MEDLINE    
Most authors agree that "fit" and "fill" of the endosteal canal is critical to the success of cementless femoral components. Yet, there exists a wide variation to the anatomic size and shape of this canal in the normal population. This paper reviews the rationale and the efficacy of using a computed tomography-generated CAD/CAM custom femoral component in cementless total hip arthroplasty. One hundred fifty-six cases (81 primary and 75 revisions) were reviewed with follow-up time of six weeks to three years (mean, 22 months). A subset of 48 hips (25 primary and 23 revisions) has been followed a minimum of two years. For the primary hips, the custom group was found to have statistically higher Harris pain scores (less pain) at all follow-up intervals as compared to a prior series by the same surgeon using an off-the-shelf (OTS) prosthesis. Revision customized hip implants had lower Harris pain and total scores than primary custom hips, but 80% were in the none or slight pain category. In revision cases, the use of custom components decreased the need for structural bone grafting and achieved stability on host bone in situations in which it was not possible using OTS components. Complications included failure by aseptic loosening of one primary and one revision case. Initial subsidence of more than 3 mm of the collarless custom design occurred in 8%, the majority being in revision cases. All cases but one appear to have stabilized. Subsidence occurred mainly in cases done early in the series.(ABSTRACT TRUNCATED AT 250 WORDS)
W L Bargar
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  -     ISSN:  0009-921X     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  1989 Dec 
Date Detail:
Created Date:  1990-01-02     Completed Date:  1990-01-02     Revised Date:  2005-03-03    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  73-8     Citation Subset:  AIM; IM    
University of California, Davis, School of Medicine, Sacramento.
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MeSH Terms
Artificial Intelligence
Biomedical Engineering
Bone Cements
Follow-Up Studies
Hip Prosthesis*
Middle Aged
Prosthesis Design*
Prosthesis Failure
Tomography, X-Ray Computed
Reg. No./Substance:
0/Bone Cements

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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