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Journal of Bone and Joint Surgery - British Volume, Vol 89-B, Issue 12,
1586-1591.
doi: 10.1302/0301-620X.89B12.19252 Copyright © 2007 by British Editorial Society of Bone and Joint Surgery Three-dimensional custom-designed cementless femoral stem for osteoarthritis secondary to congenital dislocation of the hipX. Flecher, MD, Orthopaedic Surgeon1; S. Parratte, MD, Orthopaedic Surgeon1; J.-M. Aubaniac, MD, Professor of Orthopaedic Surgery1; and J.-N. Argenson, MD, Professor and Chairman of Orthopaedic Surgery11 Service de Chirurgie Orthopedique, Hopital Sainte-Marguerite, 270 Boulevard de Sainte-Marguerite, 13009, Marseille, France. Correspondence should be sent to Professor J.-N. Argenson; e-mail: jean-noel.argenson{at}ap-hm.fr
A clinical and radiological study was conducted on 97 total hip replacements performed for congenital hip dislocation in 79 patients between 1989 and 1998 using a three-dimensional custom-made cementless stem. The mean age at operation was 48 years (17 to 72) and the mean follow-up was for 123 months (83 to 182). According to the Crowe classification, there were 37 class I, 28 class II, 13 class III and 19 class IV hips. The mean leg lengthening was 25 mm (5 to 58), the mean pre-operative femoral anteversion was 38.6° (2° to 86°) and the mean correction in the prosthetic neck was –23.6° (–71° to 13°). The mean Harris hip score improved from 58 (15 to 84) to 93 (40 to 100) points. A revision was required in six hips (6.2%). The overall survival rate was 89.5% (95% confidence interval 89.2 to 89.8) at 13 years when two hips were at risk. This custom-made cementless femoral component, which can be accommodated in the abnormal proximal femur and will correct the anteversion and frontal offset, provided good results without recourse to proximal femoral corrective osteotomy.
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