Assessment of Accuracy and Reliability in Preoperative Templating for Hip Resurfacing Arthroplasty

Olsen, Michael; Gamble, Patrick; Chiu, Mark Chih-Hung; Tumia, Nezar; Boyle, Richard A.; Schemitsch, Emil H.

doi:10.1016/j.arth.2009.01.022

Cited by 13 publications

(9 citation statements)

References 32 publications

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“…THRA is an alternative method to THA for young, active patients with hip diseases [10][11][12]. THRA enables the preservation of an intact femoral bone, potentially improves the prognosis of future hip joint arthroplasties, closely mimics the normal anatomy of the proximal part of the femur for hip articulation, optimizes stress transfer, and offers inherent stability and optimal range of movement [13,14].…”

Section: Discussionmentioning

confidence: 99%

Design of Custom-made Navigational Template of Femoral Head and Pilot Research in Total Hip Resurfacing Arthroplasty

LIANG

Zhao

Gao

et al. 2020

Preprint

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Abstract Background To develop a novel custom-made navigational template for accurate prosthesis implantation in total hip resurfacing arthroplasty (THRA) by computer-aided technology. Methods The template was produced based on data preoperatively acquired with computed tomography (CT) scan. The position of the drill guide was chosen as the anatomical axis of the femoral neck which was defined by the ligature between the center of the femoral head and another point on the centerline of proximal femoral neck. And the final direction of the drill guide was confirmed by a small valgus angle. The surface of the template was constructed as the inverse of the femoral neck surface. Then each template was formed from acrylate resin by using rapid prototyping (RP) technique. Finally, the template was tested in 18 cadavers scheduled for THRA and postoperative medical imaging was used to evaluate the accuracy and validity of the template. Results The template had a near-prefect fit with the femoral neck surface. There were no guide failures. Postoperative evaluation revealed that the Kirschner wires pass through the center of the femoral head, have a relative valgus angle to the central axis of the femoral neck and have no obvious varus-valgus angles or anterior/posterior inclination angles. So, the Kirschner wires achieved the expected implant requirement. Conclusion This study shows a novel way of guiding the prosthesis implantation accurately in THRA. The template is an excellent medium for preoperative planning and intraoperative technique, and embodies the development tendency of Computer Assisted Surgery.

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Section: Discussionmentioning

confidence: 99%

Design of Custom-made Navigational Template of Femoral Head and Pilot Research in Total Hip Resurfacing Arthroplasty

LIANG

Zhao

Gao

et al. 2020

Preprint

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“…15 Further studies investigated the reproducibility and accuracy of different software on digital images, but the relationship between surgical experience and quality of templating in THA was not examined (Table 2). 16,17 The current study had several limitations. Group B consisted of only 1 experienced surgeon with a higher accuracy than the mean of the less experienced colleagues.…”

Section: A 2bmentioning

confidence: 93%

Predictive Value of Preoperative Digital Templating in THA Depends on the Surgical Experience of the Performing Physician

Mittag

Ipach²,

Schaefer³

et al. 2012

Orthopedics

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Digital preoperative templating is increasingly used to predict the correct component size in total hip arthroplasty (THA). Experienced surgeons could avoid the new technique and rely on a digital template done by a younger colleague. We compared the accuracy of preoperative templating between orthopedic residents (group A) and an experienced orthopedic surgeon (group B). In 106 cases, the software-predicted component sizes of both groups were compared with component sizes placed surgically. An accurate prediction of the acetabular component was achieved in 63% of cases in group A compared with 88% of cases in group B (P=.001). Concerning the femoral component, accurate prediction was achieved in 89% in group A and 97% in group B (P=.021). If performed by an experienced orthopedic surgeon, digital templating is an accurate method to predict the prosthetic component size in THA.

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“…9,44 It has been suggested that undersizing of the femoral component occurs not infrequently when using digital pre-operative templating which increases the likelihood of notching. 46 In a study on composite femora a notch of 5 mm weakened the femur by 47% whereas that of 2 mm weakened it by 24%. 47 From this it can be extrapolated that a notch of 2 mm in a patient receiving a femoral component of 38 mm is relatively more serious than in a patient receiving a component of 55 mm.…”

Section: Orientation Of the Componentmentioning

confidence: 98%

The influence of the size of the component on the outcome of resurfacing arthroplasty of the hip

Shimmin¹,

Walter

Esposito

2010

The Journal of Bone and Joint Surgery. British volume

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The survivorship of contemporary resurfacing arthroplasty of the hip using metal-on-metal bearings is better than that of first generation designs, but short-term failures still occur. The most common reasons for failure are fracture of the femoral neck, loosening of the component, osteonecrosis of the femoral head, reaction to metal debris and malpositioning of the component. In 2008 the Australian National Joint Registry reported an inverse relationship between the size of the head component and the risk of revision in resurfacing hip arthroplasty. Hips with a femoral component size of /= 55 mm irrespective of gender. We have reviewed the literature to explore this observation and to identify possible reasons including the design of the implant, loading of the femoral neck, the orientation of the component, the production of wear debris and the effects of metal ions, penetration of cement and vascularity of the femoral head. Our conclusion is that although multifactorial, the most important contributors to failure in resurfacing arthroplasty of the hip are likely to be the design and geometry of the component and the orientation of the acetabular component.

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Assessment of Accuracy and Reliability in Preoperative Templating for Hip Resurfacing Arthroplasty

Cited by 13 publications

References 32 publications

Design of Custom-made Navigational Template of Femoral Head and Pilot Research in Total Hip Resurfacing Arthroplasty

Design of Custom-made Navigational Template of Femoral Head and Pilot Research in Total Hip Resurfacing Arthroplasty

Predictive Value of Preoperative Digital Templating in THA Depends on the Surgical Experience of the Performing Physician

The influence of the size of the component on the outcome of resurfacing arthroplasty of the hip

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