Preoperative planning of primary total hip arthroplasty using conventional radiographs

Abstract

Objectivethe objective of this study was to present an analog method for preoperative planning of primary total hip arthroplasty procedures based on measuring the components by overlaying the transparencies of the prosthesis on the preoperative radiographs and checking the accuracy, both for predicting the size of the acetabular and femoral components used and for restoring the offset and correcting the dysmetria.Methodsbetween March 2005 and July 2009, 56 primary total hip arthroplasty procedures performed on 56 patients at the Mario Covas State Hospital in Santo André were analyzed. The measurements on the femoral and acetabular components obtained through planning were compared with those that were used in the surgery. The offsets measured through the preoperative planning were compared with those measured on the postoperative radiographs. Dysmetria was evaluated before and after the operation.Resultsaccuracy of 78.6% (p < 0.001) in predicting the size of the acetabular component and 82.2% (p < 0.001) in predicting the femoral nail was observed. The offsets measured through preoperative planning were statistically similar to the offsets measured on the postoperative radiographs. After the operation, we observed absolute equalization in 48.2% of the cases. In 87.5%, the dysmetria was less than or equal to 1 cm and in 69.6%, it was less than or equal to 0.5 cm.Conclusionsthe accuracy was 78.6% and 82.2%, respectively, for the acetabular and femoral components. The offsets that were planned preoperatively were statistically similar to those measured on postoperative radiographs. We found absolute equalization in 48.2% of the cases.

Digital templating in total hip arthroplasty: Additional anteroposterior hip view increases the accuracy

“…This study covers multiple aspects of preoperative planning: Although several studies of analogue planning have been previously reported[11,12], our study offers an additional direct comparison with digital planning. Few studies have compared analogue and digital planning procedures.…”

É importante saber onde posicionar o marcador esférico para o planejamento digital de artroplastia de quadril?

“…O planejamento pré-operatório é consolidado como o primeiro passo para prever as dificuldades do procedimento cirúrgico, os tamanhos dos componentes e o posicionamento dos implantes na artroplastia de quadril. [1][2][3][4][5][6][7] Com o planejamento cirúrgico adequado, há redução no número de complicações associadas como discrepâncias entre membros, mau posicionamento, soltura precoce do implante, instabilidade, fratura periprotética e perda do estoque ósseo. [1][2][3][4][5][6][7] O uso de transparências fornecidas pelo fabricante das próteses e com magnificação que geralmente varia entre 100 e 130% é o método mais conhecido e consolidado, porém a reprodutibilidade do método digital já é comprovada 8 e pode ser muito útil quando o exame não foi impresso.…”

Efficacy of conventional method of preoperative templating in implant size selection in patent undergoing total hip arthroplasty

“…Turgay efy et al in study from university hospital Marburg, Germany in 2011 reported accuracy of 33.3 %for acetabular cup and 36 % for femoral component [10] . Study conducted by [11] , showed an accuracy of 78.6% in predicting the size of the acetabular component and accuracy of 82.2% in predicting the femoral stem.…”