title: Custom-design implants for severe distorted proximal anatomy of the femur in young adults followed for 4-8 years.
abstract: BACKGROUND
  Treatment of hips with abnormal anatomy is challenging, and requires demanding surgical technique. We report the preoperative planning and the functional outcome of 38 patients with severe distorted anatomy who were treated with custom implants.
  
  
  METHODS
  38 consecutive patients (48 hips) were selected for customized femoral implants. The diagnosis was arthrosis due to congenital dislocation of the hip (CDH). We used plain radiographs, CT, and CAD-CAM analysis. The mean age was 47 (22-69) years and the mean preoperative D'Aubigne score was 10 (6-12). The mean follow-up time was 6 (4-8) years.
  
  
  RESULTS
  All implants had optimal fit and fill. There were 2 revisions due to infection. No patients had thigh pain and no patients had aseptic loosening. There were 5 intraoperative and 6 postoperative complications. The mean postoperative D'Aubigne score was 17 (10-18).
  
  
  CONCLUSIONS
  Preoperative planning with modern technology and customized implants makes the procedure accurate, easier for the surgeon, and safer for the patient.
authors.affiliation: Grant Fellow Reconstruction of Joints, Hospital for Special Surgery, New York, USA. koulouvarisp@hss.edu
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Koulouvaris
authors.forename: Kosmas
authors.initials: K
authors.lastname: Stafylas
authors.forename: Thomas
authors.initials: T
authors.lastname: Sculco
authors.forename: Theodore
authors.initials: T
authors.lastname: Xenakis
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging; D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods / Q000534:rehabilitation; D005260:Female; D005269:Femur / Q000002:abnormalities*; D005500:Follow-Up Studies; D006618:Hip Dislocation, Congenital / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006621:Hip Joint / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000209:etiology / Q000601:surgery; D010347:Patient Care Planning; D011474:Prosthesis Design; D011859:Radiography; D016896:Treatment Outcome