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Accuracy of Positioning and Risk Factors for Malpositioning Custom-Made Femoral Stems in Total Hip Arthroplasty—A Retrospective Multicenter Analysis

Total hip arthroplasty (THA) is commonly performed using off-the-shelf implants. In the case of a severe mismatch between the anatomy of the proximal femur and the geometry of the stem, the use of custom-made stems might become necessary. The goal of this study was to investigate the precision of th...

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Autores principales: Anderson, Philip Mark, Heinz, Tizian, Rak, Dominik, Arnholdt, Jörg, Holzapfel, Boris Michael, Dorsch, Silke, Weißenberger, Manuel, von Eisenhart-Rothe, Rüdiger, Jaenisch, Max, Ertl, Max, Wagner, Michael, Windhagen, Henning, Rudert, Maximilian, Jakuscheit, Axel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10532930/
https://www.ncbi.nlm.nih.gov/pubmed/37763052
http://dx.doi.org/10.3390/jpm13091285
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author Anderson, Philip Mark
Heinz, Tizian
Rak, Dominik
Arnholdt, Jörg
Holzapfel, Boris Michael
Dorsch, Silke
Weißenberger, Manuel
von Eisenhart-Rothe, Rüdiger
Jaenisch, Max
Ertl, Max
Wagner, Michael
Windhagen, Henning
Rudert, Maximilian
Jakuscheit, Axel
author_facet Anderson, Philip Mark
Heinz, Tizian
Rak, Dominik
Arnholdt, Jörg
Holzapfel, Boris Michael
Dorsch, Silke
Weißenberger, Manuel
von Eisenhart-Rothe, Rüdiger
Jaenisch, Max
Ertl, Max
Wagner, Michael
Windhagen, Henning
Rudert, Maximilian
Jakuscheit, Axel
author_sort Anderson, Philip Mark
collection PubMed
description Total hip arthroplasty (THA) is commonly performed using off-the-shelf implants. In the case of a severe mismatch between the anatomy of the proximal femur and the geometry of the stem, the use of custom-made stems might become necessary. The goal of this study was to investigate the precision of the implantation of custom-made stems of one manufacturer (CTX stem, AQ Implants) and to determine risk factors for malpositioning. All patients receiving a custom-made CTX stem between 2014 and 2020 at six high-volume academic centers were retrospectively recruited. The achieved position of the stem, as determined by stem version, stem coronal angle, and implantation depth on radiographs, was compared to the plan. The influence of radiographic and demographic parameters on the position was investigated. The results revealed a high variability of the achieved implant position in relation to the preoperative plan. While the stem coronal angle only differed slightly from the intended position, the stem version and the implantation depth showed a high frequency and amount of deviation. Right stems showed significantly higher positions than planned. Surgeons must be aware of this potential problem when implanting custom-made stems.
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spelling pubmed-105329302023-09-28 Accuracy of Positioning and Risk Factors for Malpositioning Custom-Made Femoral Stems in Total Hip Arthroplasty—A Retrospective Multicenter Analysis Anderson, Philip Mark Heinz, Tizian Rak, Dominik Arnholdt, Jörg Holzapfel, Boris Michael Dorsch, Silke Weißenberger, Manuel von Eisenhart-Rothe, Rüdiger Jaenisch, Max Ertl, Max Wagner, Michael Windhagen, Henning Rudert, Maximilian Jakuscheit, Axel J Pers Med Article Total hip arthroplasty (THA) is commonly performed using off-the-shelf implants. In the case of a severe mismatch between the anatomy of the proximal femur and the geometry of the stem, the use of custom-made stems might become necessary. The goal of this study was to investigate the precision of the implantation of custom-made stems of one manufacturer (CTX stem, AQ Implants) and to determine risk factors for malpositioning. All patients receiving a custom-made CTX stem between 2014 and 2020 at six high-volume academic centers were retrospectively recruited. The achieved position of the stem, as determined by stem version, stem coronal angle, and implantation depth on radiographs, was compared to the plan. The influence of radiographic and demographic parameters on the position was investigated. The results revealed a high variability of the achieved implant position in relation to the preoperative plan. While the stem coronal angle only differed slightly from the intended position, the stem version and the implantation depth showed a high frequency and amount of deviation. Right stems showed significantly higher positions than planned. Surgeons must be aware of this potential problem when implanting custom-made stems. MDPI 2023-08-22 /pmc/articles/PMC10532930/ /pubmed/37763052 http://dx.doi.org/10.3390/jpm13091285 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Anderson, Philip Mark
Heinz, Tizian
Rak, Dominik
Arnholdt, Jörg
Holzapfel, Boris Michael
Dorsch, Silke
Weißenberger, Manuel
von Eisenhart-Rothe, Rüdiger
Jaenisch, Max
Ertl, Max
Wagner, Michael
Windhagen, Henning
Rudert, Maximilian
Jakuscheit, Axel
Accuracy of Positioning and Risk Factors for Malpositioning Custom-Made Femoral Stems in Total Hip Arthroplasty—A Retrospective Multicenter Analysis
title Accuracy of Positioning and Risk Factors for Malpositioning Custom-Made Femoral Stems in Total Hip Arthroplasty—A Retrospective Multicenter Analysis
title_full Accuracy of Positioning and Risk Factors for Malpositioning Custom-Made Femoral Stems in Total Hip Arthroplasty—A Retrospective Multicenter Analysis
title_fullStr Accuracy of Positioning and Risk Factors for Malpositioning Custom-Made Femoral Stems in Total Hip Arthroplasty—A Retrospective Multicenter Analysis
title_full_unstemmed Accuracy of Positioning and Risk Factors for Malpositioning Custom-Made Femoral Stems in Total Hip Arthroplasty—A Retrospective Multicenter Analysis
title_short Accuracy of Positioning and Risk Factors for Malpositioning Custom-Made Femoral Stems in Total Hip Arthroplasty—A Retrospective Multicenter Analysis
title_sort accuracy of positioning and risk factors for malpositioning custom-made femoral stems in total hip arthroplasty—a retrospective multicenter analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10532930/
https://www.ncbi.nlm.nih.gov/pubmed/37763052
http://dx.doi.org/10.3390/jpm13091285
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