esop ha hip prosthesis femoral stem femoral head

Planning		.

ESOP stem planning, like with most cement-less stems, is based on a highly accurate x ray balance, both in terms of enlargement and of front and side consequences. The x ray protocol for radiologists is available on request.


Mark lines : Bi-ischiatic line showing hip horizontality and optionally, the x ray U line (green lines). Line parallel to the lines above drawn from the basis of the sound lesser trochanter, used for the basis of the "prosthesis" lesser trochanter after planning (red line - here apparently no extension expected). Parallel line drawn from the sound rotation centre determining the prosthetic rotation centre (white line)
Determination of the acetubulum implant size and position (size to be checked on the side view), related moves, and marking of the initial trochanter position.

Front view planning
Stem size and position assessment Surgical x ray mark at top of greater trochanter. Size 10 or 7.5 ?
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Side view planning
Planning (less than one head, red corticals by transparency from the blue ones of the greater trochanter). Size 10 is obviously too big, but ideal 7.5 size blocking. The height of the blocking is determined based on the only visible element on the side and front view: the lesser trochanter, whose basis is projected level with the third notch in the stem.
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Side-related planning
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The mark is matched with the front in relationship to the third notch, in order to get the actual stem position, which is different from the first estimation made on the front only with the 7.5, above the top of the greater trochanter (surgical x ray mark). This shows the different positioning of the 7.5 stem in relationship to the front side estimation.

Planning related to the pelvis
The chosen 7.5 size is related by matching the height mark of the sound and prosthesed lesser trochanter basis, providing a direct reading of the neck size. Here, a short neck. The planning is then completed by determining the cut angle. The absence of medialisation can be checked against the initial marks, in order to validate the selection of a short neck.
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