The operations were performed by the same group of surgeons. All femoral components were made with cementless devices. After receiving general anesthesia or nerve block anesthesia, patients were positioned in the lateral decubitus position for all procedures. The operative technique for both groups was completed using anterolateral approaches. In the group A, surgeons performed operations based on two-dimensional planning and experience. In the group B, 3D preoperative planning was performed before surgery; after exposure of the femoral neck, the bone was cleaned to ensure a secure fit for the guides. Next, the guide was placed in a position to fit around bone in a “best fit” position. The femoral neck osteotomy was performed according to the edge of the guide (Figure 5(b)). After removing the femoral head, the acetabulum was cleaned. Then, the femoral medullary cavity was formed, and the position guide was placed on the osteotomy surface during the forming process (Figure 5(c)). After the stability testing, the femoral steam was implanted according to the guide (Figure 5(d)).

Guide plate printing (a), intraoperative osteotomy (b), intraoperative medullary cavity formation (c), and intraoperative implantation of femoral stem (d).

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