Abstract
We present the results of custom made cementless implants for treatment of osteoarthritis due to congenital disease of hip and osteonecrosis due to other diseases, where the normal anatomy was severely modified and it was impossible to insert the smallest available implant.
There were 43 patients with 52 hips, 6 males – 46 females. The mean age was 48years (22–61). The mean follow-up was 24 months (1–48). There were 32 patients with low dislocation, 14 with high dislocation, 1 with infantile septic arthritis, 1 with Hodgkin disease, 1 with dysplasia, 1 with ankylosing spondylitis, 1 with congenital varus hip and 1 with Perthes disease. Our protocol was consisted of plain radiographs and CT of the acetabulum, femur, knee condylars and foot in order to be evaluated the bone stock of acetabulum and the femur anteversion.
All the patients were evaluated – according to the Merle D’ Aubigne score – two, three and every six months after the operation. There was one complication with a proximal femur fracture in a high dislocated hip during the operation and two complications postoperatively. Both of them were high dislocated hips, and the one had paresis of sciatic nerve, that it recovered. The other had septic loosening and was undertaken revision in two stages. All the patients improved in pain, in walking ability and in range of motion.
The impossibility of using the smallest available implant due to the high deformity and the young age led us to use custom made implant. Although a long follow-up is required for these procedures the first results are very encouraging according to the recovery of the patients which were related to the restoration of hip biomechanics provided by the three dimensional neck orientation.
The abstracts were prepared by Eleni Koutsoukou. Correspondence should be addressed to him at the Hellenic Association of Orthopaedic Surgery and Traumatology (HAOST), 20, A. Fleming str, 15123 Marousi, Athens, Greece.
