"...evaluating the options in advance of surgery saves time in the OR and creates confidence in the outcome..."

The Value of Digital Planning For This Case

This patient, with significant pelvic obliquity, required a complex primary THA on the left side. Pre-operative assessment of limb length difference was crucial, in order to plan the desired correction. The surgeon commented "evaluating the options in advance of surgery saves time in the OR and creates confidence in the outcome, especially when intra-operative findings can be shown to match the expectations of the plan."

The surgeon was able to establish a consistent value for limb length discrepancy with reference to the bony landmarks of the obturator foramina, teardrops, and ischial tuberosities. A difference of 14mm was established and this information was then used to establish the correct positioning of the acetabular cup and femoral neck osteotomy, with the result that a final difference of 3mm was achieved. A high hip centre was planned for, to avoid the need for a shortening osteotomy.

The versatility of OrthoView also allowed alternative stem and cup choices to be evaluated quickly and easily and the potential outcomes compared. Switching templates in this way is much easier in a digital system as there is a comprehensive catalogue of component options readily available.

Case Details

The patient is a 78 year old woman with developmental dysplasia of the hip contributing to end-stage degenerative joint disease with significant acetabular wear and secondary pelvic obliquity. The contralateral side shows a previous THA with a high hip centre.

The patient has Dorr C type femoral bone quality. Pre-op templating indicated the width of the femoral canal and enabled the surgeon to identify and conclude that even the largest cementless fullcoat stem would have been undersized, so a cemented option (Zimmer Advocate) was chosen over the Zimmer Versys Beaded Full-coat.