A simple guide to determine the magnification of radiographs and to improve the accuracy of preoperative templating

Conn, Kevin S.; Clarke, M.; Hallett, J.P.

doi:10.1302/0301-620x.84b2.12599

Cited by 97 publications

(58 citation statements)

References 6 publications

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“…This data was not available in the current study so a standard magnification factor of 20% was used to adjust the actual measurements taken from the radiographs. However, this is the standard magnification used in most templating systems and consistent with other studies [3,10,14,15].…”

Section: Discussionsupporting

confidence: 88%

“…The distance on the post-operative side was compared to the contralateral limb which was assumed to be equal to the initial length of the operated limb before development of joint disease. Magnification was adjusted for by using a standard estimation of 20% magnification consistent with the literature [3,10,14,15]. All measurements were made on the initial post-operative radiographs and were made to the nearest millimetre by a single observer not involved in the surgical procedures.…”

Section: Methodsmentioning

confidence: 99%

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Leg Length Discrepancy in Cementless Total Hip Arthroplasty

Peck¹,

Malhotra²,

Kim³

2011

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The use of cementless total hip arthroplasty (THA) is on the increase. In order to achieve rotational and axial stability larger implants may be required than originally templated for. This could potentially result in a larger leg length inequality. Our objective was to determine whether there is greater inequality in leg length post-operatively in cementless THA as compared to cemented implants. 136 consecutive patients undergoing elective THA between June 2007 and May 2008 were included. Post-operative digital radiographs were examined to determine leg length. Twenty seven patients (20%) underwent a cemented procedure and 109 (80%) a cementless procedure. In the cemented group the mean leg length discrepancy was 7.3 mm (range 19 mm short to 21 mm long). In the cementless group the mean measured leg length discrepancy was 6.3 mm (range 18 mm short to 23 mm long). There was no significant difference between the two groups (P = 0.443). This study shows that with accurate pre-operative templating, both cemented and cementless procedures produce comparable and acceptable leg length discrepancies.

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Section: Discussionsupporting

confidence: 88%

Section: Methodsmentioning

confidence: 99%

Leg Length Discrepancy in Cementless Total Hip Arthroplasty

Peck¹,

Malhotra²,

Kim³

2011

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“…Different methods of scaling digital radiographs have been described and investigated to improve planning accuracy [17][18][19][20][21]. Accurate positioning of the reference ball at the level of the joint is crucial to achieving the greatest possible referencing reliability [17,22,23]. Another pre-requisite is precisely adjusted pelvic overviews and/or radiographs of the knee joint in two planes.…”

Section: Introductionmentioning

confidence: 99%

Digital templating in total knee and hip replacement: an analysis of planning accuracy

Kniesel

Konstantinidis

Hirschmüller

et al. 2013

International Orthopaedics (SICOT)

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Purpose The aim of this study was to determine how well preoperative size selection for total knee and hip arthroplasties based on the digital imaging with and without additional referencing correlated with the size actually implanted. Methods Size selection planning of total knee arthroplasty by digital templating was documented in 46 cases with reference ball (group A) and in 48 cases without ball (group B). In addition, prospective analysis of pre-operative planning was conducted for 52 acetabular components with reference ball (group C) and 69 without ball (group D) as well as stem planning in 38 cases with ball (group E) and 54 cases without ball (group F). The data were analysed and compared with the size of the final component selected during surgery. Results The correlation between planned and implanted size for total knee arthroplasty in group A resulted in femoral anteroposterior (AP) r =0.8622 and lateral r =0.8333 and in group B AP r =0.4552 and lateral r =0.6950. Tibial in group A was AP r =0.9030 and lateral r =0.9074 and in group B AP r = 0.7000 and lateral r =0.6376. For the acetabular components, the results in group C were r =0.5998 and group D r =0.6923. For stems, group E was r =0.5306 and group F r =0.5786. No correlation between BMI and the difference between planned and implanted size was found in any of the groups. Conclusion In the case of total hip arthroplasty there was a relatively low correlation between planned and implanted sizes with or without reference ball. For total knee arthroplasties the already high precision of size planning was further improved by the additional referencing with a reference ball.

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“…14,15 Digital templating offers a way to avoid these errors with quicker, more cost-efficient templating that can be easily stored for future reference. 16 It has also been shown that the accuracy of pre-operative digital templating in knee and hip arthroplasty meets or exceeds that of analogue templating, thus giving more support for the use of entirely digital techniques.…”

Section: Introductionmentioning

confidence: 99%

Reliability and accuracy of digital templating for the humeral component of total shoulder arthroplasty

Lee

Davis

Lane³

et al. 2014

Shoulder & Elbow

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Background: This experimental study evaluated the interobserver reliability and accuracy of pre-operative digital templating for humeral head size, stem size and neck angle for total shoulder arthroplasty. Methods: Twenty-five patients underwent a total shoulder arthroplasty with a single prosthesis. Four independent, blinded surgeons (two experienced shoulder surgeons and two PGY-6 fellows) used pre-operative radiographs and templating software to generate templates of the humeral head, stem and neck for each patient. Interobserver reliability was calculated using weighted kappa (k) analysis. Accuracy was assessed by comparing templates to actual implant sizes. Results: Interobserver reliability was fair to substantial (k ¼ 0.26 to 0.71) for head size, fair to substantial (k ¼ 0.39 to 0.72) for stem size and slight to fair (k ¼ 0.16 to 0.34) for neck angle. Templated head size, stem size and neck angle had accuracies of 53%, 77% and 68% within one size variation, respectively. Experience did not affect accuracy (p ¼ 0.11 to 0.48). Conclusions: Digital templating is not a useful guide for pre-operative surgical planning and should not be used to select a prosthesis.

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A simple guide to determine the magnification of radiographs and to improve the accuracy of preoperative templating

Cited by 97 publications

References 6 publications

Leg Length Discrepancy in Cementless Total Hip Arthroplasty

Leg Length Discrepancy in Cementless Total Hip Arthroplasty

Digital templating in total knee and hip replacement: an analysis of planning accuracy

Reliability and accuracy of digital templating for the humeral component of total shoulder arthroplasty

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