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European Journal of Orthopaedic Surgery & Traumatology

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01-07-2017 | Original Article • HIP - ARTHROPLASTY

Preoperative digital planning versus postoperative outcomes in total hip arthroplasty using a calcar-guided short stem: frequent valgization can be avoided

Authors: Karl Philipp Kutzner, Joachim Pfeil, Mark Predrag Kovacevic

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 5/2017

Abstract

Introduction

Modern total hip arthroplasty is largely dependent on the successful preservation of hip geometry. Thus, a successful implementation of the preoperative planning is of great importance. The present study evaluates the accuracy of anatomic hip reconstruction predicted by 2D digital planning using a calcar-guided short stem of the newest generation.

Methods

A calcar-guided short stem was implanted in 109 patients in combination with a cementless cup using the modified anterolateral approach. Preoperative digital planning was performed including implant size, caput–collum–diaphyseal angle, offset, and leg length using mediCAD II software. A coordinate system and individual scale factors were implemented. Postoperative outcome was evaluated accordingly and was compared to the planning.

Results

Intraoperatively used stem sizes were within one unit of the planned stem sizes. The postoperative stem alignment showed a minor and insignificant (p = 0.159) mean valgization of 0.5° (SD 3.79°) compared to the planned caput–collum–diaphyseal angles. Compared to the planning, mean femoral offset gained 2.18 (SD 4.24) mm, while acetabular offset was reduced by 0.78 (SD 4.36) mm during implantation resulting in an increased global offset of 1.40 (SD 5.51) mm (p = 0.0094). Postoperative femoroacetabular height increased by a mean of 5.00 (SD 5.98) mm (p < 0.0001) compared to preoperative measures.

Discussion

Two-dimensional digital preoperative planning in calcar-guided short-stem total hip arthroplasty assures a satisfying implementation of the intended anatomy. Valgization, which has been frequently observed in previous short-stem designs, negatively affecting offset, can be avoided. However, surgeons have to be aware of a possible leg lengthening.

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Title: Preoperative digital planning versus postoperative outcomes in total hip arthroplasty using a calcar-guided short stem: frequent valgization can be avoided
Authors: Karl Philipp Kutzner
Joachim Pfeil
Mark Predrag Kovacevic
Publication date: 01-07-2017
Publisher: Springer Paris
Published in: European Journal of Orthopaedic Surgery & Traumatology / Issue 5/2017
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-017-1948-2

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Springer Medicine

Preoperative digital planning versus postoperative outcomes in total hip arthroplasty using a calcar-guided short stem: frequent valgization can be avoided

Abstract

Introduction

Methods

Results

Discussion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Introduction

Methods

Results

Discussion

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