Skip to main content
SpringerLink
Log in

Usefullness of three-dimensional templating software to quantify the contact state between implant and femur in total hip arthroplasty

  • Original Article • HIP - ARTHROPLASTY
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Background

It would be ideal if surgeons could precisely confirm whether the planned femoral component achieves the best fit and fill of implant and femur. However, the cortico-cancellous interfaces can be difficult to standardize using plain radiography, and therefore, determining the contact state is a subjective decision by the examiner. Few reports have described the use of CT-based three-dimensional templating software to quantify the contact state of stem and femur in detail. The purpose of this study was to use three-dimensional templating software to quantify the implant–femur contact state and develop a technique to analyze the initial fixation pattern of a cementless femoral stem.

Methods

We conducted a retrospective review of 55 hips in 53 patients using a short proximal fit-and-fill anatomical stem (APS Natural-Hip™ System). All femurs were examined by density mapping which can visualize and digitize the contact state. We evaluated the contact state of implant and femur by using density mapping.

Results

The varus group (cases that had changed varus 2° by 3 months after surgery) consisted of 11 hips. The varus group showed no significant difference with regard to cortical contact in the proximal medial portion (Gruen 7), but the contact area in the distal portion (Gruen 3 and Gruen 5) was significantly lower than that of non-varus group. Density mapping showed that the stem only has to be press-fit to the medial calcar, but also must fill the distal portion of the implant in order to achieve the ideal contact state.

Conclusions

Our results indicated that quantifying the contact state of implant and femur by using density mapping is a useful technique to accurately analyze the fixation pattern of a cementless femoral stem.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Devane PA, Wraighte PJ, Ong DCG, Horne JG (2012) Do joint registries report true rates of hip dislocation? Clin Orthop Relat Res 470(11):3003–3006

    Article  PubMed Central  PubMed  Google Scholar 

  2. Shaarani R, Gavin M, Denis A (2013) Accuracy of Digital preoperative templating in 100 consecutive uncemented total hip arthroplasties. J Arthroplasty 28(2):331–337

    Article  PubMed  Google Scholar 

  3. Issa K, Pivec R, Boyd B, Harwin SF, Wuestemann T, Nevelos J, Mont MA (2012) Comparing the accuracy of radiographic preoperative digital templating for a second-versus a first-generation THA stem. Orthopedics 35(12):1028–1034

    Article  PubMed  Google Scholar 

  4. Haddad FS, Masri BA, Garbuz DS, Duncan CP (1997) The prevention of periprosthetic fractures in total hip and knee arthroplasty. Orthop Clin North Am 30(2):191–207

    Article  Google Scholar 

  5. Dalton JE, Cook SD, Thomas KA, Kay JF (1995) The effect of operative fit and hydroxyapatite coating on the mechanical and biological response to porous implants. J Bone Joint Surg Am 77(1):97–110

    CAS  PubMed  Google Scholar 

  6. Haraguchi K, Sugano N, Nishii T, Koyama T, Nishihara S, Yoshikawa H, Ochi T (2001) Comparison of fit and fill between anatomic stem and straight tapered stem using virtual implantation on the ORTHODOC workstation. Comput Aided Surg 6(5):290–296

    Article  CAS  PubMed  Google Scholar 

  7. Nishihara S, Sugano N, Nishii T, Tanaka H, Yoshikawa H, Ochi A (2003) Comparison of the fit and fill between the Anatomic Hip femoral component and the Versys Taper femoral component using virtual implantation on the ORTHODOC workstation. J Orthop Sci 8(3):352–360

    Article  PubMed  Google Scholar 

  8. Howard JL, Hui AJ, Bourne RB, McCalden RW, MacDonald SJ, Rorabeck CH (2004) A quantitative analysis of bone support comparing cementless tapered and distal fixation total hip replacements. J Arthroplasty 19(3):266–273

    Article  PubMed  Google Scholar 

  9. Aamodt A, Kvistad KA, Andersen E, Lund-Larsen J, Eine J, Benum P, Husby OS (1999) Determination of Hounsfield value for CT-based design of custom femoral stems. J Bone Joint Surg Br 81(1):143–147

    Article  CAS  PubMed  Google Scholar 

  10. Crowe JF, Mani VJ, Ranawat CS (1979) Total hip replacement in congenital dislocation and dysplasia of the hip. J Bone Joint Surg Am 61(1):15–23

    CAS  PubMed  Google Scholar 

  11. Kajino Y, Kabata T, Maeda T, Iwai S, Kuroda K, Fujita K, Tsuchiya H (2013) Strict component positioning is necessary in hip resurfacing. J Orthop Sci 18(2):290–297

    Article  PubMed  Google Scholar 

  12. Hounsfield GN (1980) Computed medical imaging. Science 210(4465):22–28

    Article  CAS  PubMed  Google Scholar 

  13. Eckrich SG, Noble PC, Tullos HS (1994) Effect of rotation on the radiographic appearance of the femoral canal. J Arthroplasty 9(4):419–426

    Article  CAS  PubMed  Google Scholar 

  14. Rubin PJ, Leyvraz PF, Aubaniac JM, Argenson JN, Estève P, de Roguin B (1992) The morphology of the proximal femur. A three-dimensional radiographic analysis. J Bone Joint Surg Br 74(1):28–32

    CAS  PubMed  Google Scholar 

  15. Knight JL, Atwater RD (1992) Preoperative planning for total hip arthroplasty. Quantitating its utility and precision. J Arthroplasty 7:403–409

    Article  PubMed  Google Scholar 

  16. Inoue D, Kabata T, Maeda T, Kajino Y, Fujita K, Hasegawa K, Yamamoto T, Tsuchiya H (2015) Value of computed tomography-based three-dimensional surgical preoperative planning software in total hip arthroplasty with developmental dysplasia of the hip. J Orthop Sci 20(2):340–346

    Article  PubMed  Google Scholar 

  17. Sariali E, Mouttet A, Pasquier G, Durante E, Catone Y (2009) Accuracy of reconstruction of the hip using computerized three-dimensional pre-operative planning and a cementless modular neck. J Bone Joint Surg Br 91(3):333–340

    Article  CAS  PubMed  Google Scholar 

  18. Hassani H, Cherix S, Ek ET, Rüdiger HA (2014) Comparisons of preoperative three-dimensional planning and surgical reconstruction in primary cementless total hip arthroplasty. J Arthroplasty 29(6):1273–1277

    Article  PubMed  Google Scholar 

  19. McKellop H, Ebramzadeh E, Niederer PG, Sarmiento A (1991) Comparison of the stability of press-fit hip prosthesis femoral stems using a synthetic model femur. J Orthop Res 9(2):297–305

    Article  CAS  PubMed  Google Scholar 

  20. Garg A, Deland J, Walker PS (1985) Design of intramedullary femoral stems using computer graphics. Eng Med 14(2):89–93

    Article  CAS  PubMed  Google Scholar 

  21. Reuben JD, Chang CH, Akin JE, Lionberger DR (1992) A knowledge-based computer-aided design and manufacturing system for total hip replacement. Clin Orthop Relat Res 285:48–56

    PubMed  Google Scholar 

  22. Testi D, Simeoni M, Zannoni C, Viceconti M (2004) Validation of two algorithms to evaluate the interface between bone and orthopaedic implants. Comput Methods Progr Biomed 74(2):143–150

    Article  Google Scholar 

  23. Adam F, Hammer DS, Pape D, Kohn D (2002) Femoral anatomy, computed tomography and computer-aided design of prosthetic implants. Arch Orthop Trauma Surg 122(5):262–268

    Article  PubMed  Google Scholar 

  24. Ries MD, Lynch F, Jenkins P, Mick C, Richman J (1996) Varus migration of PCA stems. Orthopedics 19(7):585–586

    Google Scholar 

  25. Huppertz A, Radmer S, Asbach P, Juran R, Schwenke C, Diederichs G, Hamm B, Sparmann M (2011) Computed tomography for preoperative planning in minimal invasive total hip arthroplasty: radiation and cost analysis. Eur J Radiol 78(3):406–413

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8641, Japan

    Daisuke Inoue, Tamon Kabata, Toru Maeda, Yoshitomo Kajino, Kenji Fujita, Kazuhiro Hasegawa, Takashi Yamamoto, Tomoharu Takagi, Takaaki Ohmori & Hiroyuki Tsuchiya

Authors
  1. Daisuke Inoue
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tamon Kabata
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Toru Maeda
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yoshitomo Kajino
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kenji Fujita
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kazuhiro Hasegawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Takashi Yamamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Tomoharu Takagi
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Takaaki Ohmori
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Hiroyuki Tsuchiya
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tamon Kabata.

Ethics declarations

Conflict of interest

This study was funded by Zimmer, Holdings, Inc. All authors declare that we received research funding from Zimmer Holdings, Inc in this study.

Ethical approval

All procedures performed in studies were in accordance with the ethical standards of our institutional ethical committee. In accordance with the requirements of this study, all patients were provided informed consent.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Inoue, D., Kabata, T., Maeda, T. et al. Usefullness of three-dimensional templating software to quantify the contact state between implant and femur in total hip arthroplasty. Eur J Orthop Surg Traumatol 25, 1293–1300 (2015). https://doi.org/10.1007/s00590-015-1705-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00590-015-1705-3

Keywords

Search

Navigation