Abstract
Introduction
Restoration of the femoral head centre during THR should theoretically improve muscle function and soft tissue tension. The aim of this study was to assess whether 3D planning and an accurately controlled neck osteotomy could help recreate hip anatomy.
Methods
100 consecutive THR patients received OPSTM 3D femoral planning. For each patient a 3D stem+head position was pre-operatively planned which restored the native head height, restored global offset after cup medialisation and reproduced anterior offset, in the superior-inferior, medial-lateral and anterior-posterior directions respectively. The femoral osteotomy was planned preoperatively and controlled intra-operatively with a patient specific guide. All procedures were performed through a posterior approach with a TriFit/Trinity uncemented implant combination. Post-op implant position was determined from CT.
Results
The mean difference between planned and achieved head height was 0.9mm (−1.2mm to 4.6mm). The mean difference between planned and achieved medial offset was −0.9mm (−6.2mm to 3.1mm). The mean difference between planned and achieved anterior offset was 3.2mm (−0.4mm to 6.6mm). Resultant 3D change between the planned and achieved head centre was 4.4mm (0.6mm to 9.1mm). The change in anterior offset was strongly correlated (r=0.78) to the change in achieved stem anteversion in comparison to the plan; mean values of 16.3° and 10.5° respectively.
Conclusions
In this single centre pilot study, femoral centre of rotation was accurately reproduced by using 3D templating and controlling the femoral neck osteotomy with a patient-specific guide.
