Feasibility and anteversion accuracy of a patient-specific instrument for femoral prosthesis implantation in total hip arthroplasty

Abstract

Background: The aim of this study was to evaluate the precision and feasibility of patient-specific instruments (PSI) in total hip arthroplasty (THA) as compared to the traditional free-hand (FRH) approach.

Methods: During the period of January 1, 2021 to December 31, 2022, a randomized allocation was used for patients receiving unilateral primary THA to either the PSI or conventional operation group. The placement and size of the PSI were specifically chosen to guide femoral neck resection and prosthesis implantation. The study analyzed component positions and evaluated radiographic and clinical outcomes in 30 patients who received PSI-assisted THAs and 30 patients who received FRH THAs. This study was registered at China Clinical Trial Registry (number: ChiCTR2300072325) on June 9th, 2023.

Results: The use of PSI in THA resulted in significantly higher precision in achieving the desired component position as compared to the FRH approach. The PSI group showed significantly smaller absolute errors of femoral anteversion (p < 0.001). No significant differences were found in operation time, intra-operative blood loss, hospitalization duration, or time to walk after surgery.

Conclusion: In conclusion, the application of patient-specific instruments in THA provides a simple and reliable solution to enhance the precision of femoral prosthesis placement with high accuracy and feasibility. This study highlights the potential benefits of using the PSI in THA.

Keywords: 3D printing; Femoral anteversion; Patient-specific instrument; Surgical guide; Total hip arthroplasty.