Determining the accuracy of preoperative total hip replacement 2D templating using the mediCAD® software

Abstract

Background Templating is a preoperative planning procedure that improves the efficiency of the surgical process and reduces postoperative complications of total hip arthroplasty (THA) by improving the precision of prediction of prosthetic implant size. This study aimed to evaluate the accuracy of the preoperative cup and stem size digital 2D templating of THA with mediCAD® software and find the factors that influence the accuracy, such as indication for surgery, patients’ demographics, implant brand, and the assessors’ grade of education. Methods We retrospectively retrieved 420 patient template images of all patients who underwent THA between March 2018 and March 2021. Templating of all included images was processed using mediCAD® software a day before surgery by a newcomer physician to hip arthroplasty course (PGY-2 orthopedic resident or hip surgery fellow). Preoperative templating cup and stem sizes were compared with the actual inserted implant sizes. Result After excluding ineligible patients, this study included 391 patients, 193 (49.4%) males and 198 (50.6%) females with a mean age of 43.3 ± 14.9. The average cup sizes predicted before and after surgery were 52.12 ± 14.28 and 52.21 ± 15.05 respectively, and the mean delta cup size (before and after surgery) was 2.79 ± 2.94. The delta stem size before and after surgery has a mean value of 1.53 ± 1.49. The acetabular cup components, measured within ± 0, ± 1, and ± 2 sizes, were 28.9%, 63.9%, 83.1% accurate, respectively. The femoral stem design component measured within ± 0, ± 1, and ± 2 sizes were 27.2%, 61.0%, 78.6% accurate, respectively. Wagner Cone® stem brand, DDH patients, and females showed significantly higher accuracy of stem size templating. Revision THA has the lowest accuracy in terms of cup size templating. The compression of accuracy rate between resident and fellow revealed no significant differences. Also, no significant difference was detected between the accuracy of templating performed in the first months with the second months of the arthroplasty course period. Conclusion Our study showed that under mentioned condition, templating using mediCAD® has acceptable accuracy in predicting the sizes of femoral and acetabular components in THA patients. Digital software like mediCAD® remains favorable because of the short learning curve, user-friendly features, and low-cost maintenance, leading to level-up patient care and THA efficacy. Further studies are necessary for clarifying the role of the assessor’s experience and expertise in THA preoperative templating. Level of evidence Level III (retrospective observational study).

Slight pelvic obliquity is normal in a healthy population: a cross‐sectional study

“…PO angle was measured as the angle between the horizontal plane and the inter-teardrop line (Fig. 4) [5] using mediCAD ® software (version 3.5, Hectec, Landstuhl, Germany) [9]. Heidt et al compared the variations of the O'Brien method and revealed that the angle formed by the horizontal reference line and the inter-teardrop line was most reliable for measuring pelvic obliquity [7].…”

Comparison of low-dose (162 mg) and high-dose (650 mg) Aspirin prophylaxis following total joint arthroplasty: a prospective cohort study

“…Hemispherical porous-coated Trilogy cups (Zimmer, Inc.) and porous-coated Pinnacle cups (DePuy Orthopaedics, Inc.) were used for the acetabular component. 2D templating was performed on all patients before surgery using mediCAD software 29 . The perioperative care was the same for TKA patients described above, except THA patients did not receive cocktail injections and oxycodone.…”

Accuracy analysis of artificial intelligence-assisted three-dimensional preoperative planning in total hip replacement

“…In short, the surgeon must adjust the prosthesis model and its position according to his/her own experience, thereby extending the operation time and increasing the risk of bleeding and infection. [ 9 , 10 ] Three-dimensional (3D) preoperative planning based on computed tomography (CT) data (e.g., Mimics, MAKO, and ZedHip) is thought to improve the accuracy of prosthesis placement and reduce surgical complications;[ 11 , 12 ] however, this method is limited in terms of the complicated planning steps and the time involved, restricting its clinical application.…”