Computed Tomography–Based Custom-Made Stem for Dysplastic Hips in Japanese Patients

We investigated 55 hips of 53 patients with dysplastic hips. Individual computed tomography data were used in the manufacturing of cementless custom-made stems made of Ti-6Al-4V. The proximal one third was coated using porous coating covered with hydroxyapatite coating. The average age at surgery was 60 years and the average follow-up was 7 years. Five patients (9%) complained of postoperative thigh pain. According to Engh's radiologic classification system, there was bone-ingrown fixation in all hips. The cortical index and canal flare index were lower, and stem diameter was greater in the 11 hips (20%) with severe stress shielding than in the remaining 44 hips. Although the results obtained with this custom-made stem system for dysplastic hips were excellent, stress shielding is still an issue.