Addressing a Complex Proximal Femoral Deformity With Custom Cutting Guides Using 3D-Computer Design Software: A Case Report and 2-year Follow-Up

Abstract

We report a case of a 23-year-old female with a history of congenital proximal femoral deformity and malunion of a prior proximal femoral corrective osteotomy, who presented seeking treatment for debilitating end-stage arthritis of her hip. Consideration for total hip arthroplasty (THA) for this patient was complicated by her young age and the complexity of her proximal femoral deformity. A 3-dimensional bone model of the patient’s femur was created using digital reconstructive software based on preoperative CT-imaging and used to plan our corrective osteotomy and arthroplasty component specifications. Using the detailed characterization of the femoral morphology, custom cutting guides were designed to fit uniquely into the correct position and ensure a high degree of accuracy with our osteotomy cuts. This unique case highlights the use of 3D-modeling software and printing technology for detailed surgical planning and precise execution in patients with complex deformities or otherwise abnormal anatomy.