A New Digital Preoperative Planning Method for Total Hip Arthroplasties

Abstract

Preoperative templating is an important part of a THA. The ability to accurately determine magnification of the hip on the radiograph and apply identical magnification to the radiograph and template will improve accuracy of preoperative templating of THA. We designed a templating method using a new way of determining the hip magnification with a linear relationship between magnification of the hip and the reference object on top of the pubis symphysis; the relationship was determined on 50 radiographs. We then compared our method with two other templating methods: an analog method assuming an average hip magnification of 15% and a digital method determining the hip magnification with a one-to-one relationship between the reference object and the hip. All methods were reproducible. Uniform undersizing occurred when templating with the digital method based on the oneto-one relationship; the analog method best predicted the implanted prosthesis size, closely followed by our new digital templating method; the new method will be particularly applicable for preoperative THA when analog methods are replaced by digital methods.

Acetate Templating on Digital Images Is More Accurate Than Computer-based Templating for Total Hip Arthroplasty

“…Intraobserver ICC values showed almost perfect agreement (ICC [ 0.8) for both acetabular and femoral components when using both templating methods, suggesting both methods are highly reproducible. Our ICC values correspond well to previous studies, which found ICC values ranging from 0.7 to 0.97 [6,10,15,21]. Our study showed that experience level did not have an effect on accuracy nor intraobserver variability.…”

“…However, to the best of our knowledge, no study has shown that errors in templating at the time of surgery directly leads to inferior clinical outcomes. Our study found substantial interobserver ICC value agreement for acetate templating for the femoral component and digital templating for the acetabular and femoral components, which is similar to several studies using the analog or digital templating methods [6,15]. However, values were lower than that quoted by Gamble et al [10], which found ICC values ranging from 0.8 to 0.94.…”

“…The development of digital radiography and Picture Archiving and Communication Systems has in turn led to the development of digital templating software. Several studies have looked at the validity and reliability of digital templating compared with analog templating [6,10,12,15,18,25]. Digital templating has been shown to have good reliability and validity [2,6,10,12,15,18,25].…”

“…Several studies have looked at the validity and reliability of digital templating compared with analog templating [6,10,12,15,18,25]. Digital templating has been shown to have good reliability and validity [2,6,10,12,15,18,25]. However, digital templating requires the availability of digital templating software on numerous workstations and assumes that hospital IT departments will provide timely updates of the built-in templates within the software.…”

The utility of digital templating in Total Hip Arthroplasty with Crowe type II and III dysplastic hips

“…With the development of digital images, this conventional technique is gradually becoming impractical because film-based radiographs may no longer exist. Some studies have reviewed the utility of a digital templating technique [3,5,9,10,12,14,19], but most of them focussed on comparison of the accuracy between acetate templating and digital templating [3,9,10,12,14,19]. In most of these studies, the primary diagnosis of THA was osteoarthritis or was not specified (Table 1).…”