Preoperative sizing of hip hemiarthroplasties to accurately estimate head size from non- standardised pelvic radiographs: Can it be done?

Crosswell, Sebastien; Akehurst, Harold; Ramiah, Reagon; Navadgi, Basalingappa

doi:10.1016/j.injury.2019.08.025

Cited by 8 publications

(14 citation statements)

References 15 publications

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“…Similarly, Green et al [ 4 ] templated head size to within 2 mm in 94% of cases. Croswell et al [ 2 ] looked at two magnification constants, a regression-through-the-origin, and intercept parameter models and reported root mean square errors ranging from 3.3 to 1.4 mm (root mean square error for this study was 1.1 mm). Our finding that implant (femoral head) sizes were within 1 mm of the contralateral side in 69% and within 2 mm in 91% of patients suggest that using the contralateral implant as a template is as accurate if not more accurate than using digital templating techniques in hemiarthroplasty.…”

Section: Discussionmentioning

confidence: 71%

“…To the best of our knowledge, there are no studies looking at implant size in bilateral hemiarthroplasties. Crosswell et al [ 2 ] report that an “ internal audit showed good co-relation in hemiarthroplasties head size for those patients who went on to fracture both hips ”; however, they do not report any specific numbers. Two studies have previously looked at bilateral variations in proximal femur geometry using radiographs.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, owing to our limited numbers, we have not reported on outcomes nor whether using the contralateral implant information influences clinical outcomes. However, the benefits of templating are well documented [ 2 , 3 , 5 , 7 , 15 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…Prompt treatment and restoration of mobility have been shown to improve outcomes. Approximately 60% of these fractures are intracapsular for which hip hemiarthroplasty is a key intervention [ 1 , 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…Predicting femoral head diameter for hemiarthroplasties can influence theatre efficiency and improve patients’ intraoperative care. However, pre-operative sizing using templating of implants in hip fracture patients requiring a hemiarthroplasty is often difficult due to non-standard radiographs, absence of a calibration marker, poor marker placement, variable patient position, and in many institutions a lack of templating facilities [ 2 , 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

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How Accurate is the Use of Contralateral Implant Size as a Template in Bilateral Hemiarthroplasty?

Marappa-Ganeshan

Sim

Sidhom

et al. 2020

IJOO

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Purpose Accurately predicting implant size for hemiarthroplasties offers an important contribution to theatre efficiency and patients’ intraoperative care. However, pre-operative sizing using templating of implants in hip fracture patients requiring a hemiarthroplasty is often difficult due to non-standard radiographs, absence of a calibration marker, poor marker placement, variable patient position, and in many institutions a lack of templating facilities. In patients who have previously undergone a hemiarthroplasty on the contralateral side, surgeons can use the contralateral implant size for pre-operative planning purposes. However, the accuracy of doing this has not previously been reported. The aim of this study was to investigate the reliability of using an in situ contralateral implant as a predictor of implant size on the contralateral side. Methods A retrospective review of our local neck of femur fracture (NOF) database was undertaken to identify patients who had bilateral hip hemiarthroplasty. Operative records were reviewed to establish the size of prostheses used at operation. Correlation, agreement, and reliability analysis were performed using the least squares, Bland–Altman plot, and intra-class correlation coefficient (ICC) methods, respectively. Results Operative records were identified for 45 patients who had bilateral hemiarthroplasties. There was a difference in implant size used in 58% of cases. Of these 77% required a larger implant on the right. Implant sizes were within 1 mm of the contralateral side in 78% and within 2 mm in 91% of patients. However, in 9% of patients, there was a discrepancy greater than 2 mm with some cases having up to 6 mm discrepancy. Correlation coefficient was 0.83 and the ICC 0.90. Conclusions The findings in this study indicated that using the size of a contralateral implant can be used as a reliable indicator of head size in cases of bilateral hemiarthroplasty. However, the surgeon should remain cautious as there is a one in ten chance of there being a 3 mm or more difference in implant size.

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Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

How Accurate is the Use of Contralateral Implant Size as a Template in Bilateral Hemiarthroplasty?

Marappa-Ganeshan

Sim

Sidhom

et al. 2020

IJOO

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Can the intra-operative measurement of the diameter of the femoral head help surgeons to choose the best size of the acetabular cup?

Muñoz-Mahamud

Chimeno

Tornero

et al. 2022

International Orthopaedics (SICOT)

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Purpose We hypothesized that the intra-operative measurement of the femoral head may increase the accuracy of the acetabular cup size optimal selection in total hip arthroplasty (THA). The purpose of this clinical research was to analyze the correlation between the estimated cup size from intra-operative measurement of the femoral head and the pre-operative templated cup size. Methods A prospective observational single-center study was conducted from June 2019 to January 2020 including primary THA (n = 100). All cases were pre-operatively templated. The measurement of the anterior–posterior diameter of the femoral head was routinely intra-operatively performed. Any definitive implanted cup was considered as “oversized” when the size was > 4 mm than the diameter of the native head. Results The median (interquartile range) size of the implanted cup, pre-operative planned cup size, and diameter of the femoral head were measured 52 (50–54) mm, 50 (48–54) mm and 49 (45–51) mm, respectively. Pre-operative planned size cup accurately predicted the implanted cup or differed in only one size (2 mm) in 77 (78%) cases. Otherwise, intra-operative femoral head measurement method accurately predicted the implanted or differed in only one size (2 mm) in 51 (87%) cases (p = 0.097). Conclusion The intra-operative femoral head measurement is a simple and reliable tool to help the surgeons choose the best size of the acetabular cup and is as reliable as the pre-operative templating in order to avoid cup oversizing in THA. Utmost caution is warranted whenever the cup reamer is > 4 mm than the anterior–posterior diameter of the native head.

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Intraoperative live measurement of femoral head size for acetabular cup sizing: simple, accurate, and green!

Assi,

Boulos,

Haykal

et al. 2024

International Orthopaedics (SICOT)

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Preoperative sizing of hip hemiarthroplasties to accurately estimate head size from non- standardised pelvic radiographs: Can it be done?

Cited by 8 publications

References 15 publications

How Accurate is the Use of Contralateral Implant Size as a Template in Bilateral Hemiarthroplasty?

How Accurate is the Use of Contralateral Implant Size as a Template in Bilateral Hemiarthroplasty?

Can the intra-operative measurement of the diameter of the femoral head help surgeons to choose the best size of the acetabular cup?

Intraoperative live measurement of femoral head size for acetabular cup sizing: simple, accurate, and green!

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