Accuracy and reproducibility of preoperative three-dimensional planning for total hip arthroplasty using biplanar low-dose radiographs : A pilot study

Mainard, Didier; Barbier, Olivier; Knafo, Yohann; Belleville, R.; Mainard-Simard, L.; Gross, Julius

doi:10.1016/j.otsr.2017.03.001

Cited by 59 publications

(42 citation statements)

References 27 publications

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“…Recently, preoperative CT three‐dimensional (3D) planning 13‐16 has been used to optimize sizing, position, and orientation of components in THA. The femoral component has been underinvestigated when compared with the acetabular cup.…”

Section: Introductionmentioning

confidence: 99%

Uncemented femoral stem orientation and position in total hip arthroplasty: A CT study

Belzunce

Henckel

Laura

et al. 2020

Journal Orthopaedic Research

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In total hip arthroplasty (THA), accurate positioning of components is important for the functionality and long life of the implant. Femoral component version has been underinvestigated when compared with the acetabular cup. Accurate prediction of the femoral version on the preoperative plan is particularly important because a well‐fitting uncemented stem will, by definition, press‐fit into a version that is dictated by the anatomy of the proximal femur. A better understanding of this has recently become an unmet need because of the increased use of uncemented stems and of preoperative image‐based planning. We present the first, three‐dimensional (3D) comparison between the planned and achieved orientation and position of the femoral components in THA. We propose a comparison method that uses the 3D models of a, computed tomography‐generated (CT‐generated), preoperative plan and a postoperative CT to obtain the discrepancy in the six possible degrees of freedom. We ran a prospective study (level 2 evidence) of 30 patients undergoing uncemented THA to quantify the discrepancy between planned and achieved femoral stem orientation and position. The discrepancy was low for femoral stem vertical position and leg length, and varus‐valgus and anterior‐posterior orientation. The discrepancy was higher for femoral version with a mean (±SD) of −1.5 ± 7.8 deg. Surgeons should be aware of the variability of the eventual position of uncemented stems in THA and acknowledge the risk of achieving a less‐than‐optimal femoral version, different from the preoperative 3D CT plan.

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Section: Introductionmentioning

confidence: 99%

Uncemented femoral stem orientation and position in total hip arthroplasty: A CT study

Belzunce

Henckel

Laura

et al. 2020

Journal Orthopaedic Research

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“…Careful planning is crucial for the success of total hip arthroplasty (THA), affecting the occurrence of intraoperative and postoperative complications, the recovery process, and the long-term results [7,25]. Hence, preoperative templating plays a central role.…”

Section: Introductionmentioning

confidence: 99%

“…Hence, preoperative templating plays a central role. Currently, two-dimensional (2D) templating using conventional X-rays is the gold standard [8,25,30]. In the literature, the reported accuracy of preoperative templating in determining the exact size is 35-48% [11,15,30].…”

Section: Introductionmentioning

confidence: 99%

“…In the literature, the reported accuracy of preoperative templating in determining the exact size is 35-48% [11,15,30]. If the accuracy is extended to predict to one size, the value is increased to 60-94% [15,25]. Therefore, computed tomography (CT) scans were developed, demonstrating a clearly higher accuracy in size prediction (estimated at 94-100%) [13,30,31].…”

Section: Introductionmentioning

confidence: 99%

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Three-dimensional templating in hip arthroplasty: the basis for template-directed instrumentation?

Savov

Budde

Tsamassiotis

et al. 2020

Arch Orthop Trauma Surg

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Introduction Computed tomography-based three-dimensional models may allow the accurate determination of the center of rotation, lateral and anterior femoral offsets, and the required implant size in total hip arthroplasty. In this cadaver study, the accuracy of anatomical reconstruction was evaluated using a three-dimensional planning tool. Materials and methods A total of eight hip arthroplasties were performed on four bilateral specimens. Based on a computed tomography scan, the position and size of the prosthesis were templated with respect to the anatomical conditions. Results On average, all parameters were reconstructed to an accuracy of 4.5 mm and lie within the limits recommended in the literature. All prostheses were implanted with the templated size. Conclusions The exact anatomy of the patient and the required size and position of the prosthesis were precisely analyzed using a templating software. Based on the present findings, the development of template-directed instrumentation is conceivable using this method. However, further technical features (e.g., navigation or robot-assisted surgery) are required for improved precision for implant positioning.

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“…and even facilitate the concept of on-time delivery of instruments and implants, potentially without the need for advanced imaging and the use of custom or patient-specific guides or instrumentation. 10 Determining planned implant size can be performed by many methods including the use of overlays on conventional acetate radiographs, digital templating 11 with or without the use of calibration to advanced imaging with EOS, 12 computed tomography (CT), 13 or magnetic resonance imaging (MRI), 14 and even customized patient specific guides. 15 Conventional planning has been shown to be at least as reliable as digital planning, though the current literature remains controversial about this.…”

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confidence: 99%

Radiographic Native Femoral Head Size Correlates with Acetabular Cup Size in Primary Total Hip Arthroplasty

et al. 2019

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There is very little literature on whether a simple radiographic measurement of native femoral head size correlates with implanted acetabular cup size. We hypothesized that there would be a high correlation between the radiographically measured native femoral head and implanted acetabular component size in primary total hip arthroplasty (THA). We conducted a retrospective study of 277 consecutive patients who underwent primary THA. Patients with prior contralateral THA or a history of congenital deformity were excluded (n = 95). We used the postoperative anteroposterior (AP) pelvic view to calibrate the image using known implanted femoral head component size. We then measured the diameter of the contralateral native femoral head under the assumption that femoral heads are generally symmetrical in patients. Two of the authors performed all measurements. To determine if native femoral head size was correlated with acetabular component size we used the Pearson correlation coefficient (r). There was a high correlation between contralateral native femoral head size and acetabular component size (r = 0.86, 95% confidence interval [CI]: 0.82–0.89). The median difference in radiographically measured native femoral head size and acetabular component size was 7 mm (interquartile range [IQR] = 5–8). Our data showed a high correlation between acetabular component size and radiographically measured contralateral native femoral head size, with the difference being 7 mm. In addition to verifying the actual femoral head size with calipers during surgery, this simple radiographic measurement, which could be done on the affected or contralateral hip, may help surgeons to plan better and improve preoperative templating in primary THA.

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Accuracy and reproducibility of preoperative three-dimensional planning for total hip arthroplasty using biplanar low-dose radiographs : A pilot study

Abstract: Level III. Retrospective case-control study.

Cited by 59 publications

References 27 publications

Uncemented femoral stem orientation and position in total hip arthroplasty: A CT study

Uncemented femoral stem orientation and position in total hip arthroplasty: A CT study

Three-dimensional templating in hip arthroplasty: the basis for template-directed instrumentation?

Radiographic Native Femoral Head Size Correlates with Acetabular Cup Size in Primary Total Hip Arthroplasty

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