Overview of Personalized Hip Arthroplasty
Total hip arthroplasty was developed through two distinct surgical philosophies/approaches: ANATOMICAL (preservation of hip joint’ physiology: anatomy, soft-tissue balance, and therefore kinematics) Vs MECHANICAL (implants aligned relative to extra-articular reference plane/axis – no consideration of the native hip’ axial anatomy). Hip resurfacing is a great example of a patient specific procedure. Other options are large diameter head (LDH) THA and functional Alignment (FA) techniques. Next decades will serve to compare clinical outcomes/cost effectiveness of those attractive, personalized implantation techniques.
Personalized THA with a large diameter head (LDH) and either a monobloc or dual-mobility configuration offers an impingement-free range of motion and a reduced risk of dislocation. The supraphysiological range of motion (ROM) offered by a large head–neck offset can compensate for any abnormal spinopelvic mobility and surgical imprecision. Moreover, an LDH bearing with low clearance exerts a high suction force, providing hip micro-stability. With appropriate biomechanical reconstruction, LDH THA can restore normal gait parameters, allowing unrestricted activities and resulting in high patient satisfaction.