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.
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