Results with a Custom-Made Stem

Summary

Ninety-one cementless custom-made stems manufactured according to CT (computed tomography) data were investigated. Patients average age at surgery was 59 years (range, 44-79) with a mean follow-up of 5 years and 4 months (range, 4–7 years). The JOA (Japanese Orthopaedic Association) score was improved from a preoperative mean of 45 points (range, 12–74) to a postoperative mean of 88 points (range, 49–98). Four patients (4.4%) complained of thigh pain. To date, no patients have undergone revision of the stem. Radiographically, according to Engh’s classification system, there was bone-ingrown fixation in 86 hips (94.5%), stable fibrous fixation in 2 (2.2%), and unstable fixation in 3 (3.3%). Cortical bone width ratio was smaller and stem diameter was greater in the 5 stress-shielding hips than in the remaining 86 hips. Cortical bone width ratio was smaller in 4 hips with a complaint of thigh pain than in the remaining 87 hips. Careful indication is needed for patients with thin cortical bone width. Although further follow-up is needed, the results obtained with this custom-made stem system over a mean follow-up period of 5 years and 4 months were excellent.