The 3-dot circle: A reliable method for safe and efficient digital templating of the acetabular component

Arnaout, Firas; Dewan, Varun; Paliobeis, Christos

doi:10.1016/j.jor.2018.03.027

Cited by 7 publications

(3 citation statements)

References 18 publications

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“…Templating markers are commonly used in AP pelvic X-rays for calibration purposes. The KingMark device is a double calibration device, which uses markers placed anteriorly and posteriorly to the pelvis [ 10 ]. KingMark templating has been shown to improve the accuracy in predicting components in THR surgery compared to a single marker template [ 11 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

The Accuracy of Digital Preoperative Templating in Primary Total Hip Replacements

Girgis,

Kohli,

Kouklidis

et al. 2023

Cureus

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BackgroundDigital templating is an essential part of preoperative planning in elective total hip replacement (THR) surgery. The goals of templating are to predict femoral and acetabular implant sizes, to assess leg length, offset, and implant positioning. Templating markers such as the KingMark device (Brainlab, Munich, Germany) have been developed to improve the accuracy. Although templating is commonly used in many centres, there are challenges related to the accuracy of the process, such as true magnification ideal positioning of the pelvis and hips/body habit (obesity). ObjectivesThe aim of this study was to assess the accuracy of preoperative templating in THR patients, and to assess the difference between templating performed with and without the KingMark device. MethodsOur retrospective study included 642 consecutive patients who had primary THR at the Royal Bournemouth Hospital in the UK. Four hundred fifty-three (71%) of patients had the KingMark device on their templated radiographs. Patients who had hybrid total hip replacements using an uncemented acetabular component and cemented femoral component were included in the study. Digital templating was done using TraumaCad software (Brainlab). Analysis of the accuracy of predicting component size has been evaluated by comparing preoperative planned sizes with implanted sizes as documented by the surgeons and labels attached to the operative note. ResultsThe templated size corresponded to the actual femoral implant used in approximately 65.2% of cases. When femoral prostheses within one size above or below the templated size were included,the accuracy of preoperative templating rose to 97.2%. Regarding the uncemented acetabular component, the templated size corresponded to the actual acetabular implant used in 46.3% of cases. When acetabular cup within one size above or below the templated size were included, the accuracy of preoperative templating rose to 87.5%. Similarly, there was minimal difference between the predicted templated sizes using the KingMark device compared to templating performed without it. ConclusionsPreoperative templating is an essential part in optimizing the outcome of THRs. Templating allows the surgeon to estimate the size of the components to be used. It also provides a starting point, from which the surgeon can proceed from, and saves valuable intraoperative time by assessing the level of the femoral neck osteotomy and the degree of lateral rasping. Multiple factors affect the accuracy of preoperative templating including the patient BMI, external rotation of the hip and surgeon's experience. Although there are different methods of templating, digital templating with 2D radiographs is likely the most cost-effective and efficient process available at this time.

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Section: Discussionmentioning

confidence: 99%

The Accuracy of Digital Preoperative Templating in Primary Total Hip Replacements

Girgis,

Kohli,

Kouklidis

et al. 2023

Cureus

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“…acetabular cup size. 26 A high-interrater reproducibility for the femoral head size indicates that this radiographic measurement is comparatively easy to obtain. 27 Of interest, our measurement is based on radiographic measurements, which cannot account for the potential variable thickness of articular cartilage.…”

Section: Discussionmentioning

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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“…18 Si la radiografía digital no dispone de marcadores, otro método plausible es el de los tres puntos. 19 II. Acortamiento de la extremidad, pérdida de offset y tensión de partes blandas: Dada la migración superomedial de la cabeza femoral, existe un acortamiento de la extremidad comprometida, al mismo tiempo que una disminución del offset global de la cadera.…”

Section: Migración Medial O Superomedial De La Cabeza Femoralunclassified

Protrusio acetabular en artroplastía total de cadera: diez tácticas para un buen resultado quirúrgico

Bengoa

López²,

Dabed³

et al. 2021

Revista Chilena de Ortopedia y Traumatología

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ResumenLos pacientes candidatos a artroplastía total de cadera con protrusio acetabular asociada generan distintos desafíos en los equipos quirúrgicos. Múltiples estrategias han sido utilizadas a lo largo de los años para optimizar los resultados. Mediante una revisión de la evidencia actualizada disponible, proponemos diez tácticas a realizar en el manejo de estos pacientes que pueden mejorar y hacer predecible el tratamiento de un paciente con protrusio acetabular al que se le realiza una artroplastía total de cadera. Nivel de Evidencia V.

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The 3-dot circle: A reliable method for safe and efficient digital templating of the acetabular component

Abstract: This study presents a simple, reproducible and accurate method for templating of the minimum safest acetabular component diameter.

Cited by 7 publications

References 18 publications

The Accuracy of Digital Preoperative Templating in Primary Total Hip Replacements

The Accuracy of Digital Preoperative Templating in Primary Total Hip Replacements

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

Protrusio acetabular en artroplastía total de cadera: diez tácticas para un buen resultado quirúrgico

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