Reproducing the proximal femur anatomy: 3D preoperative planning and custom cutting guides

Abstract

Successful outcomes of total hip arthroplasty (THA) depend upon patient-specific factors, surgical technique, and appropriate implant selection. Proper surgical technique requires meticulous preoperative templating, followed by accurate and precise component positioning, a modifiable risk factor which may prevent poor clinical function following THA. Restoration of native hip biomechanics serves to optimize implant wear and THA stability. Closely approximating native hip biomechanics also avoids abductor insufficiency, limb-length inequality, and early construct failure. A key challenge to accurate component placement includes accommodating for variations in individual patient anatomy, functional spinopelvic mobility, and intraoperative positioning. Three-dimensional (3D) preoperative templating and patient-specific instrumentation (PSI) have emerged to enhance the surgical precision of bone resection and individualize component placement in THA.