Chinese Journal of Tissue Engineering Research ›› 2012, Vol. 16 ›› Issue (48): 8943-8947.doi: 10.3969/j.issn.2095-4344.2012.48.003

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Selection of prosthesis size before total hip arthroplasty

Li Jian-long, Li Yi-zhong, Lin Jin-kuang, Yao Xue-dong, Zhuang Hua-feng   

  1. Department of Orthopedics, Second Clinical Medical College of Fujian Medical University, Quanzhou 362000, Fujian Province, China
  • Received:2012-04-05 Revised:2012-05-23 Online:2012-11-25 Published:2013-03-14
  • Contact: Li Yi-zhong, Master, Professor, Chief physician, Department of Orthopedics, Second Clinical Medical College of Fujian Medical University, Quanzhou 362000, Fujian Province, China doctorlyz@sina.com
  • About author:Li Jian-long★, Master, Attending physician, Department of Orthopedics, Second Clinical Medical College of Fujian Medical University, Quanzhou 362000, Fujian Province, China speedflyer@126.com

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Abstract:

BACKGROUND: A good press-fit between the femoral component and the cross-section of medullary cavity of proximal femur is very important. The accuracy of preoperative measurement of prosthesis model by template measurement method was low. It was necessary to search a new method for preoperative prediction of prosthesis model.
OBJECTIVE: To measure the minimum medial dimension of medullary cavity of femoral neck and the intramedullary dimension of femoral isthmus by CT in order to predict the size of suitable femoral prosthesis in total hip arthroplasty.
METHODS: Clinical data of 52 patients (61 hips) undergoing primary total hip arthroplasty were collected. The size of the femoral stem was accurately measured from preoperative CT film based on the medial dimension of medullary cavity of femoral neck and the intramedullary dimension of femoral isthmus. Conventional preoperative template measurement method was served as control. The feasibility and accuracy of the two methods to predict the size of the prosthesis was analyzed.
RESULTS AND CONCLUSION: The medial dimension of medullary cavity of femoral neck and the intramedullary dimension of femoral isthmus were correlated fairly well with sizes of the stems (r=0.97-0.99, P < 0.05). There were 47.5% cases of CT-isthmus measurement method predicted sizes were excellence, and the accuracy of the CT-isthmus measurement method was better than that of the template measurement method, especially in the age below or equal to 65 years. The results of the medial-dimension measurement method of femoral neck predicted sizes were excellent in 52.5%, and the accuracy of the medial-dimension measurement method was better than that of the template measurement method, especially in the age more than 45 years. CT-isthmus measurement method has better clinical value in the patients with the age below or equal to 65 years or in the patients with narrow medullary cavity of the femoral stem, while the medial-dimension measurement method of femoral neck has better accuracy in the prediction of the prosthesis model preoperatively in the patients with the age more than 45 years or in the patients with large medullary cavity of the femoral stem. It suggested that the application of the two methods was feasible for prediction of femoral component in total hip arthroplasty.

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