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Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
Published on: February 27, 2018
Are component positioning and prosthesis size associated with hip resurfacing failure?
David R Marker1, Michael G Zywiel, Aaron J Johnson
1Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, 2401 West Belvedere Avenue, Baltimore, MD, USA.
BMC Musculoskeletal Disorders
|October 6, 2010
Summary
Surgeon experience improves metal-on-metal hip resurfacing component placement precision. Component size, not positioning, was linked to implant longevity, with smaller components failing more often.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Implant Technology
Background:
- Metal-on-metal hip resurfacing (MMHR) has a documented learning curve.
- Surgeon experience may influence implant positioning and patient outcomes.
Purpose of the Study:
- To evaluate if surgeon experience impacts MMHR component positioning.
- To determine if positioning and component size correlate with implant survival.
Main Methods:
- Analysis of 361 MMHRs with a mean 59-month follow-up.
- Radiographic assessment of acetabular inclination and femoral stem-neck angles.
- Comparison of positioning and component sizes between failed and surviving implants.
Main Results:
- Improved femoral component positioning precision with increased surgeon experience.
- No significant difference in positioning angles between failed and surviving implants.
- Smaller mean femoral component diameter in failed hips (44mm) vs. surviving hips (47mm).
Conclusions:
- Early learning curve MMHR procedures show variations in component positioning.
- Implant positioning is not associated with failure, barring specific risk factors.
- Caution advised for patients with small femoral necks, particularly during the early learning curve.
