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Custom hip arthroplasty

Kalin Mihov, Svetoslav Dobrilov, Maksim Zagorov, Atanas Tabakov

Abstract


     Total hip replacement is rapidly growing procedure because of  pain relief ,restoring range of motion  and patient`s satisfaction. Primary go is to restore individual geometry of patient`s hip joint, long term components survival and most important- improving patient`s quality of life.

  In past decades this surgery has several limitations as patient`s age, bone morphology ( incl. anatomical deformities) ,previous surgeries ,etc.  Recently , with the development of modern implants ( cups and stems) these limitations are past.

 Young patients indicated for THA are always great challenge , because their functional requirements , life expectancy ,anatomical variations (  due to congenital or acquired disorders) , greater mobility and higher risk of aseptic loosening.

  Standart  cementless  stems have some unsolved issues as fixed  intra / extramedular  dimentions, proximal stress shielding, impingement, etc. They are based on 2D-planning and often have mismatch between acetabular and femoral center of rotation.

  Custom femoral  stems are based on specific 3D- scan of the hip joint, which presents  individual  shape of  acetabulum and especially femoral canal. This allows  optimal bone support for the stem, preserving bone substance , excellent  contact bone-stem and most important- restores center of rotation.

  For the period 2010-2014  we  operated  16 patients , 8 were  with Osteoarthrosis (OA); 4-with Avascular necrosis (AVN) ; 2 with dysplastic hips (DDH) and two with posttraumatic osteoarthrosis . Follow up is 6-42 months.

  We perform THA with modified  posterior surgical approach with minimal femoral reaming, due to individual femoral rasp with the same size  as the customized  femoral stem.

 During  the follow up period we found no complications,Harris Hip Score was 97 pts.  and  85%  of  the patients had regular physical exercises for 3 weeks.


Keywords

Osteoarthrosis, THA, cementless stems, custom hip, 3D-planning

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DOI: http://dx.doi.org/10.14748/ssm.v48i3.1686

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About The Authors

Kalin Mihov
Department of Ortopedics and Traumatology, University Hospital "St. Marina" Varna, M.D.

Svetoslav Dobrilov
Department of Ortopedics and Traumatology, University Hospital "St. Marina" Varna, M.D.

Maksim Zagorov
Department of Ortopedics and Traumatology, University Hospital "St. Marina" Varna, M.D.

Atanas Tabakov
Department of Ortopedics and Traumatology, University Hospital "St. Marina" Varna, M.D. resident

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