58 delegates and 6 faculty from the major tertiary orthopaedic referral speciality centres gathered in London yesterday to discuss and debate the impact of 3D imaging and HipPLAN proprietary software in the design and manufacture of Custom implants for the accurate reconstruction of the young adult dysplastic/ dysmorphic hip.

This was our inaugural London meeting, in previous years the event has been staged in Yverdon, Switzerland, but high levels of UK interest from the ‘young adult’ orthopaedic speciality interest was the main driver in bringing the event to London, and what an event it was! With Mr Paul Jairaj in the Chair, delegates were introduced to the 1st speaker of the day, Professor Hedi Sariali from the Pitie Salpetriere University Hospital, Paris, who described in detail the morphological variants according to ‘Nobles’ index, requiring Custom femoral components. Delegates were then treated to the remarkable ‘live’ planning of two contrastingly complex cases to demonstrate the message of this opening presentation. Such were the levels of interest in this CT based 3D pre- operative planning tool (HipPLAN), an impromptu lunchtime breakout session was hastily arranged!

Next to the podium was the assured presence of Dr Alexis Nogier of the Clinique Maussins- Nollet, Paris, who stressed the importance of cup positioning and orientation during a Custom THR procedure.

Alexis then shared with us his clinical results from a vast experience of over 120 cases undertaken per year, at his Paris clinic, through the ‘soft tissue sparing’ procedure known as Direct Anterior Approach or DAA, regarded as an aid to the rapid recovery of young, fit and active patients.

The morning session continued with contributions from Mr Paul Culpan, Consultant Orthopaedic Surgeon at The Royal London Hospital, which is the largest trauma centre in Europe. Mr Culpan is a pioneer in the field of trauma surgery having designed a unique pelvic plating system used by surgeon globally. Mr Culpan is a huge advocate for 3D CT based pre- operative planning and stressed the need for surgeons to utilise HipPLAN software to reduce the margins for error.

Mr David Stitson, Consultant Orthopaedic Surgeon at then Plymouth Nuffield Hospital, closed the morning session with a thought provoking session on neck modularity in standard implants. David has the widest UK experience of the Symbios SPS ODEP 3A* rated modular implant, with over 400 implantations to his name.

Used in conjunction with 3D CT planning, David believes that in the high demand active patient cohort, the benefits of accurate joint reconstruction significantly outweigh the theoretical marginal risks of an additional implant interface. Mr Stitson reviewed the outcomes of this implant from the National Joint Registry, the implant out performing other cementless implants in that same category in almost every measured outcomes parameter.

Mr Pramod Achan, Chief of Orthopaedics at St Barts NHS Trust delivered a most captivating presentation to open the afternoon session, certainly generating searching questions from notable attendees such as Mr Martyn Porter and Professor Tim Board of Wrightington Hospital (the ‘home’ of Sir John Charnley who carried our the very first low friction arthroplasty [Total Hip Replacement] procedure in 1958).

Mr Achan’s presentation on femoral stem anteversion and femoral metaphyseal helitorsion- torsional deformity in the proximal femur above the level of the lesser trochanter- and the impact of this geometric entity on soft tissue function & implant performance was a source of considerable ongoing debate throughout the afternoon, particularly the effects of correct helitorsion on the wear and tear characteristics of implants.

And so it was left to Mr Tahir Khan to bring the formal presentations to a close, with an assured assessment of the young adult Perthes, SUFE patient. Mr Tahir Khan, Consultant Paediatric Orthopaedic Consultant at the Royal National Orthopaedic Hospital, Stanmore, with a super sub- interest in complex children’s orthopaedic problems, discussed Custom THR after multiple corrective osteotomy surgery using examples of our most recent cases undertaken.

The meeting closed promptly and on time and delegates were in reflective mood as they were wished a very safe journey home, not before I was approached by a number of delegates who were keen to request our assistance going forward!

More posts from the 2017 London Custom Meeting can be seen on twitter:

#londoncustommeeting

Please keep on eye on the website for early news and pre- registration details for the 2018 HipPLAN User Group Meeting.

Footnote: A very special thanks to my colleagues Sharon and Sue at the Symbios UK Ltd Exeter Administrative Office. Without their help and dogged determinedness, this event would not have been possible.


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