Computer assisted hip resurfacing using patient-specific instrument guides

Abstract

Hip resurfacing is considered to be a viable alternative to total hip replacement in the treatment of osteoarthritis, especially for younger and more active patients. There are, however, several disadvantages reported in the literature, due to difficult surgical exposure and the technical challenges of the intraoperative procedure. Surgical errors, such as notching of the femoral neck, tilting of the femoral component in excess varus, or improper prosthesis seating, can result in early failure of the procedure. In this chapter we discuss the use of patient-specific instrument guides as an accurate and reliable image-guided method for the placement of the femoral and acetabulum components during hip resurfacing. The out- come of patient-specific guided procedures depends on many factors, starting with the accurate depiction of the anatomy in a preoperative image modality, the careful selection of registration surfaces for the guide, the accuracy of the guide creation, as well as the reliability of the guide registration intraoperatively. We will discuss in detail how current research is addressing these points in patient-specific instrument guided hip resurfacing applications.