An artificial hip joint (total hip replacement) must fit perfectly. Although standardized hip prostheses are available in many sizes, they do not cater for every anatomical variation. In patients with deformities (dysplasia), following previous surgery, or with very narrow medullary canals in the femur, the ‘off-the-shelf’ prosthesis reaches its limits. This is where the customized hip prosthesis comes into its own. It is precisely adapted to the shape of the pelvic bone and the femoral neck. This reduces the risk of the implant becoming loose or causing pain. A custom-made prosthesis may also be necessary for a subsequent revision (replacement operation) if there is little bone substance available.
Manufacturing begins long before implantation. A three-dimensional image of the hip joint is created using computed tomography (CT). Using this data, the surgeon plans the prosthesis using a virtual 3D model. The prosthesis stem and the hip socket are shaped so that they fit seamlessly into the existing bone structure. Manufacturing is often carried out using 3D printing technology with high-quality titanium. These modern implants guarantee a high degree of stability.
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Based on CT data, the customized hip prosthesis is precisely adapted to the patient’s anatomy to ensure optimal stability and mobility.
The implantation of an artificial hip joint is a routine procedure, but should be carried out in a certified endoprosthetics center. There, doctors have the necessary expertise. A crucial factor for success is access to the hip joint. Today, surgery is almost always performed using minimally invasive techniques. This surgical method is particularly gentle on the muscles: the muscles are not cut through, but simply moved to one side. This results in less blood loss, better wound healing and less pain immediately after the operation.
A common question in the clinic concerns the type of fixation. Hip prostheses generally consist of several components: the stem, the prosthetic head, the inlay (sliding layer) and the cup. Whether the prosthesis is cemented or cementless depends on the bone quality:
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Cementless: The prosthesis is ‘pressed’ into the bone (press-fit). The rough surface fuses with the bone. This is now generally done in younger patients with good bone quality.
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Cemented: Here, the surgeon uses bone cement to fix the stem securely in place immediately. With cemented prostheses, the artificial joint can bear a full load straight away. This is often advisable for older people with osteoporosis.
Hybrid solutions are also possible. Thanks to the precise fit of a custom-made prosthesis, excellent fixation is often achieved even without cement.
The bearing surfaces are crucial for ensuring the new joint moves smoothly. A ceramic head is usually combined with an inlay made of highly cross-linked polyethylene. This tried-and-tested combination minimizes wear. This is because if particles rub off, this can lead to inflammation and loosening (prosthesis loosening). With a perfectly fitting custom-made prosthesis, there are fewer micro-movements, which potentially extends the implant’s lifespan.
Thanks to minimally invasive techniques, mobilization often begins on the day of the operation. Rapid mobilization is important to prevent thrombosis and regain mobility. Rehabilitation (outpatient or inpatient) helps to normalize gait. As the individual anatomy has been respected, the artificial hip joint feels ‘natural’ more quickly for many patients (‘Forgotten Joint’). The patient’s mobility and return to everyday life are accelerated by the precise fit.
The customized hip prosthesis is the high-end solution in hip replacement surgery. It is particularly worthwhile in cases of complex anatomy or special requirements. Combined with a minimally invasive surgical technique performed by an experienced surgeon, it offers the chance to live a pain-free and active life. Whether cemented or cementless: the concept individually selected by the doctor determines long-term success.
What is the difference compared to a standard prosthesis?
Standard prosthesis types are produced in fixed sizes. The customized hip prosthesis is precisely tailor-made for the patient based on CT data.
When is a custom-made prosthesis advisable?
It is particularly advisable in cases of severely deformed bones, following accidents, in cases of congenital malformation (dysplasia) or when standard implants would not fit anatomically.
How long does a customized hip prosthesis last?
As with standard prostheses, a lifespan of 15 to 20 years or more is generally expected today. The precise fit can minimize the risk of premature loosening.
