Templating Hip Arthroplasty

Alnahhal, Amro; Aslam-Pervez, Nayef; Sheikh, Hassaan Q.

doi:10.3889/oamjms.2019.088

Cited by 28 publications

(20 citation statements)

References 51 publications

(51 reference statements)

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“…These figures certainly stressed that an experienced hand also has a significant role to play inaccurate preoperative templating. 24 Similarly, it has been found that the training and experience levels of the attending surgeon have no effect on the accuracy of acetabular component templates, but these factors do have a serious impact in determining the accuracy and precision of the femoral component template.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Femoral Malrotation in Offset Templating for Total Hip Arthroplasty: A Cadaveric Study and Curvilinear Analysis

Schutte¹,

Navarro

Shaikh

et al. 2021

The Journal of Hip Surgery

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Techniques allow assessment of preoperative offset in hip arthroplasty. This study assessed femoral rotation in preoperative offset templating using a cadaveric model. Ten femurs were imaged at degrees of rotation. Offset was measured. A generalizable equation predicting change in offset was derived with a curvilinear model. Statistically significant differences at rotational positions were found. For 30 degrees of internal rotation, 2.1 mm change in adjusted mean offset existed; for 30 degrees of external rotation, 8.4 mm change existed. Improved awareness of malrotation of the proximal femur and templating adjustments may improve total hip arthroplasty outcomes. This study reflects level of evidence III.

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Section: Discussionmentioning

confidence: 99%

The Effect of Femoral Malrotation in Offset Templating for Total Hip Arthroplasty: A Cadaveric Study and Curvilinear Analysis

Schutte¹,

Navarro

Shaikh

et al. 2021

The Journal of Hip Surgery

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“…This may be a reflection of the relatively small number of cases in the study. In a recent systemic review, preoperative templating resulted in a significant increase in the accuracy of THA [ 21 ]. However, the exclusive dependence on templating resulted in correct size-matching in only up to 60% of cases in other previous studies [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Limb Length Inequality in Patients After Primary Total Hip Arthroplasty: Analysis of Radiological Assessment and Influencing Risk Factors Based on a District General Hospital Experience of 338 Cases

Abouelela¹,

Mubark²,

Nagy³

et al. 2021

Cureus

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Background and objectiveLimb length inequality (LLI) is a frequent and recurring issue after total hip arthroplasty (THA). It is often a source of patient dissatisfaction and litigation. This study reviewed the incidence of LLI in a UK District General Hospital in light of published evidence and identified the preoperative and intraoperative risk factors for LLI. MethodsThis was a retrospective study involving 380 consecutive unilateral primary total hip replacements over a period of 12 months. Patient demographics, clinical, radiological, and operative details were collected from the National Joint Registry (NJR) database and hospital records. The limb length was measured radiologically [OrthoView Workstation TM (Materialise UK, Southampton, UK)], pre-and postoperatively, by two authors. They assessed the vertical distance between the intra-acetabular teardrop line and the medial apex of the lesser trochanters. After excluding complex primary, revision cases, tilted X-rays, and hip replacement for trauma patients, 338 cases were included in the final analysis. ResultsThe mean postoperative LLI was 2.7 mm with a standard deviation (SD) of 6.56 mm. Only 5.3% of patients had LLI >15 mm. None of the studied variables showed a statistically significant correlation with LLI. Even with the apparent difference in the mean LLI between templating and not templating before surgery (2.19 vs. 3.53), the p-value was 0.06, which was below the level of statistical significance. There was a weakly positive Pearson correlation between body mass index (BMI) and the incidence of lengthening of the limb. ConclusionThe cause of LLI after THA is multifactorial. No single factor can be singled out as the most significant contributor to this complication.

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“…THA is now the gold standard procedure for orthopedic patients with extensive hip joint pathologies such as developmental dysplasia of the hip [ 3 ] and end-stage hip osteoarthritis [ 4 ]. Although the most common indication of THA is osteoarthritis, the procedure is also indicated for the management of displaced fracture of the femoral neck in younger patients, juvenile rheumatoid arthritis, ankylosing spondylitis, hip fractures, bone tumors (benign and malignant), arthritis that is associated with Paget’s disease, and unreduced traumatic dislocation of the hip joint [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2022

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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).

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Templating Hip Arthroplasty

Cited by 28 publications

References 51 publications

The Effect of Femoral Malrotation in Offset Templating for Total Hip Arthroplasty: A Cadaveric Study and Curvilinear Analysis

The Effect of Femoral Malrotation in Offset Templating for Total Hip Arthroplasty: A Cadaveric Study and Curvilinear Analysis

Limb Length Inequality in Patients After Primary Total Hip Arthroplasty: Analysis of Radiological Assessment and Influencing Risk Factors Based on a District General Hospital Experience of 338 Cases

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

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