title: Custom made total hip replacement--necessary or not?
abstract: Indication and technical requirements analyses for custom made THR have been made. Indications for the use of custom made THR and the results achieved have been assessed according to the available literature and compared to the results of standard THR. There is a significant divergence in indications, late results and production costs. Clinical reports focus mostly on individual project metric data preparation method, technical aspects (such as shape or used material) or implantation method. Biomechanical analysis of achievable range of motion, ways of load transportation and equalization of frequently substantial discrepancy in leg length, is more hypothetical. The difficulty stems from the soft tissue quality which cannot be determined precisely, the cause of contracture or dynamic dysfunction triggered by the change of muscle action axis and muscle force over the joint, after changes of offset and joint axis of motion. In complicated cases, preoperative planning of a single approach/solution strategy can pose severe difficulties which would be hard to overcome during operation. Analysis was based on 2 cases.
authors.affiliation: Zakład Biomechaniki Klinicznej, Katedra Fizjoterapii, Akademia Medyczna we Wrocławiu.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Pozowski
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Paprocka-Borowicz
authors.forename: Sławomir
authors.initials: S
authors.lastname: Jarzab
authors.forename: Patryk
authors.initials: P
authors.lastname: Romaszkiewicz
authors.forename: Maciej
authors.initials: M
authors.lastname: Starzyk
mesh_terms: D000328:Adult; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D005260:Female; D006618:Hip Dislocation, Congenital / Q000601:surgery; D006621:Hip Joint / Q000503:physiopathology; D006801:Humans; D007870:Leg Length Inequality / Q000517:prevention & control; D008297:Male; D011300:Preoperative Care / Q000379:methods; D011474:Prosthesis Design; D017755:Prosthesis Fitting / Q000379:methods*; D016059:Range of Motion, Articular; D012086:Reoperation; D016474:Weight-Bearing