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...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-08-01
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| Series: | Journal of Personalized Medicine |
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| Online Access: | https://www.mdpi.com/2075-4426/13/9/1285 |
| _version_ | 1797579283633274880 |
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| author | Philip Mark Anderson Tizian Heinz Dominik Rak Jörg Arnholdt Boris Michael Holzapfel Silke Dorsch Manuel Weißenberger Rüdiger von Eisenhart-Rothe Max Jaenisch Max Ertl Michael Wagner Henning Windhagen Maximilian Rudert Axel Jakuscheit |
| author_facet | Philip Mark Anderson Tizian Heinz Dominik Rak Jörg Arnholdt Boris Michael Holzapfel Silke Dorsch Manuel Weißenberger Rüdiger von Eisenhart-Rothe Max Jaenisch Max Ertl Michael Wagner Henning Windhagen Maximilian Rudert Axel Jakuscheit |
| author_sort | Philip Mark Anderson |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-03-10T22:33:48Z |
| format | Article |
| id | doaj.art-2a581c3f1fb7482cb11eac996dad6291 |
| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-03-10T22:33:48Z |
| publishDate | 2023-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Personalized Medicine |
| spelling | doaj.art-2a581c3f1fb7482cb11eac996dad62912023-11-19T11:30:06ZengMDPI AGJournal of Personalized Medicine2075-44262023-08-01139128510.3390/jpm13091285Accuracy of Positioning and Risk Factors for Malpositioning Custom-Made Femoral Stems in Total Hip Arthroplasty—A Retrospective Multicenter AnalysisPhilip Mark Anderson0Tizian Heinz1Dominik Rak2Jörg Arnholdt3Boris Michael Holzapfel4Silke Dorsch5Manuel Weißenberger6Rüdiger von Eisenhart-Rothe7Max Jaenisch8Max Ertl9Michael Wagner10Henning Windhagen11Maximilian Rudert12Axel Jakuscheit13Department of Orthopedics, König-Ludwig-Haus, University of Würzburg, Brettreichstraße 11, 97070 Wuerzburg, GermanyDepartment of Orthopedics, König-Ludwig-Haus, University of Würzburg, Brettreichstraße 11, 97070 Wuerzburg, GermanyDepartment of Orthopedics, König-Ludwig-Haus, University of Würzburg, Brettreichstraße 11, 97070 Wuerzburg, GermanyDepartment of Orthopedic Surgery, Klinikum Grosshadern, Ludwig-Maximilians-University of Munich, Marchioninistraße 15, 81377 Munich, GermanyDepartment of Orthopedic Surgery, Klinikum Grosshadern, Ludwig-Maximilians-University of Munich, Marchioninistraße 15, 81377 Munich, GermanyDepartment of Orthopedics, König-Ludwig-Haus, University of Würzburg, Brettreichstraße 11, 97070 Wuerzburg, GermanyDepartment of Orthopedics, König-Ludwig-Haus, University of Würzburg, Brettreichstraße 11, 97070 Wuerzburg, GermanyDepartment of Orthopaedics and Sports Orthopaedics, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Straße 22, 81675 Munich, GermanyDepartment of Orthopedics and Trauma Surgery, University Hospital Bonn, Venusberg Campus 1, 53127 Bonn, GermanyDepartment of Orthopaedic Surgery, Klinikum Rechts der Isar, Technical University of Munich, Ismaninger Straße 22, 81675 Munich, GermanyDepartment of Orthopaedics and Trauma Surgery, Klinikum Nürnberg Campus Süd, Paracelsus Medical University, Breslauer Straße 201, 90472 Nürnberg, GermanyDepartment of Orthopaedic Surgery, Annastift Hannover, Medical School Hannover, Borries Str. 1-6, 30625 Hannover, GermanyDepartment of Orthopedics, König-Ludwig-Haus, University of Würzburg, Brettreichstraße 11, 97070 Wuerzburg, GermanyDepartment of Orthopedics, König-Ludwig-Haus, University of Würzburg, Brettreichstraße 11, 97070 Wuerzburg, GermanyTotal 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.https://www.mdpi.com/2075-4426/13/9/1285total hip arthroplastycustom-made implantradiographships |
| spellingShingle | Philip Mark Anderson Tizian Heinz Dominik Rak Jörg Arnholdt Boris Michael Holzapfel Silke Dorsch Manuel Weißenberger Rüdiger von Eisenhart-Rothe Max Jaenisch Max Ertl Michael Wagner Henning Windhagen Maximilian Rudert Axel Jakuscheit Accuracy of Positioning and Risk Factors for Malpositioning Custom-Made Femoral Stems in Total Hip Arthroplasty—A Retrospective Multicenter Analysis Journal of Personalized Medicine total hip arthroplasty custom-made implant radiographs hips |
| 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 | total hip arthroplasty custom-made implant radiographs hips |
| url | https://www.mdpi.com/2075-4426/13/9/1285 |
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