Cementless Total Hip Arthroplasty Using a Custom-Made Femoral Component with Sand-Blasted Surface

Summary

This study reviews the clinical and radiographical results of 98 cementless total hip arthroplasties (THAs) using custom-made, 125-mm-long femoral components with a sand-blasted surface at a mean of 52 months follow-up. All 76 patients were diagnosed as having secondary osteoarthritis of the hip, and their mean age at operation was 54 years. With the Japan Orthopaedic Association’s scoring system for osteoarthritis of the hip (JOA hip score), 93 hips (95%) were clinically evaluated as excellent, 4 (4%) as good, and 1 (1%) as poor. Radiographically, 86 hips (87%) were assessed as bone-ongrown fixation, 8 (9%) as stable fibrous fixation, and 4 (4%) as unstable. Both clinical and radiographical results were better than those reported elsewhere for cementless custom-made femoral components with surface finish insufficient for bone ongrowth. The four unstable hips had intraoperative cracks or varus positioning of the components. Such technical errors were thought to be due to the length of the stems, which was designed to obtain the maximum fill of implant in the medullary canal. We therefore reduced the stem length of the custom-made femoral components to 100 mm.