Femoral Stem Placement for Total Hip Arthroplasty Using Three-Dimensional Custom Surgical Guides in Dogs: A Cadaveric Study

Abstract

Abstract Objective The aim of this study was to assess the feasibility and accuracy of femoral stem placement for total hip arthroplasty (THA) using three-dimensional (3D)-printed custom surgical guides (CSGs). Study Design Computed tomography (CT) scans of 7 cadaveric adult medium-sized (23.2–30.0 kg) dog femurs were acquired. A virtual plan was made using 3D models, and CSGs were designed to aid in optimal femoral stem positioning. Two surgeons with limited experience in THA performed stem implantation with CSGs for each limb. Following stem implantation, CT scans were repeated, and final stem alignment was measured and then compared with the preoperative virtual plan. Results The median difference between planned and postoperative stem alignment with CSGs was –6.2 degrees (interquartile [IQR] –15.2 to 2.1 degrees) for stem version, 2.3 degrees (IQR –0.6 to 3.9 degrees) for varus/valgus angulation, and 1.8 degrees (IQR –0.1 to 2.9 degrees) for cranial/caudal stem angulation. The median difference in stem depth was 1.5 mm (IQR –1.2 to 3.1). Mean surgical procedure time for CSG surgeries was 44.1 ± 20.5 minutes for femoral stem implantation. Conclusion The use of CSGs resulted in successful femoral stem placement by two novice THA surgeons. Novice THA surgeons may benefit from CSGs in the learning stages of THA, but further investigation is recommended prior to clinical implementation.