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Updated: Jun 15, 2026
09:31
Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
Published on: February 27, 2018
Custom uncemented revision stems based on a femoral classification
Jia Hua1, Peter S Walker, Sarah K Muirhead-Allwood
1Institute of Orthopaedics and Musculoskeletal Science, University College London, London, UK. j.hua@ucl.ac.uk
Summary
Four custom HA-coated hip stems effectively addressed cavitary defects in revision hip surgery. Patients experienced improved pain and function, with minimal migration and preserved bone stock over four years.
Area of Science:
- Orthopedic surgery
- Biomaterials science
- Bone biology
Background:
- Revision hip surgery presents challenges due to bone defects.
- Custom-designed implants are needed for complex cases.
- Hydroxyapatite (HA) coating promotes bone integration.
Purpose of the Study:
- To evaluate the efficacy of four custom-designed HA-coated hip stems.
- To assess clinical outcomes and implant stability in revision hip arthroplasty.
- To investigate bone preservation around the implants.
Main Methods:
- Retrospective analysis of 175 revision hip surgery cases.
- Utilized four types of HA-coated hip stems based on bone condition.
- Assessed patient outcomes using Harris Hip Score.
- Measured axial migration radiographically over 4 years.
- Evaluated bone density changes using DEXA scans.
Main Results:
- All four stem types were sufficient for various cavitary defects.
- Significant improvements in hip pain and function (Harris Hip Score).
- Axial migration averaged less than 2 mm over 4 years.
- Bone preservation was observed in all regions up to 4 years.
- Migration patterns were consistent across all stem designs.
Conclusions:
- Custom HA-coated hip stems provide a versatile solution for revision hip surgery.
- The implant design facilitates initial stability and appropriate strain transfer.
- Long-term radiographic and bone density data support the implant's efficacy.
- This approach leads to favorable clinical outcomes and bone maintenance.
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