The Rate of Correctly Planned Size of Digital Templating in Two Planes—A Comparative Study of a Short-Stem Total Hip Implant with Primary Metaphyseal Fixation and a Conventional Stem

(1) Background: Preoperative templating is mainly conducted on an anteroposterior pelvic overview X-ray. For short stem hip arthroplasty, the choice of the optimal size is especially crucial to avoid complications. Thus, the study aimed to determine if there is an increased rate of correctly planned sizes using two radiological planes. (2) Methods: 50 patients with a conventional stem and 100 with a short stem total hip arthroplasty were analyzed. Without knowing the implanted size, three independent orthopedic surgeons performed digital templating: once using the anteroposterior pelvic overview only and once using the lateral view in addition. (3) Results: The rate of correctly planned sizes (+/−1 size compared to the inserted size) of templating with one plane was 86.3% ± 9.5% in short stem hip arthroplasty and 88.4% ± 6.0% in conventional stem arthroplasty. By adding the lateral view, the rate of correctly planned sizes was 89.9% ± 12.0% for the short stem hip arthroplasty group and 89.4% ± 9.8% for the conventional group (p > 0.1). (4) A potential positive effect of preoperative templating using an additional lateral X-ray view for short stem implants may be suggested based on the results of this study, which did, however, not reach statistical significance.

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Implications of component size and calibration error on digital templating for total hip arthroplasty. A visual matrix from a simple mathematical model

International Journal of Computer Assisted Radiology and Surgery ◽

10.1007/s11548-021-02367-4 ◽

2021 ◽

Author(s):

Christoph Kolja Boese ◽

Tim Rolvien ◽

Matthias Trost ◽

Michael Frink ◽

Jan Hubert ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Standard Procedure ◽

Calibration Error ◽

Optimal Size ◽

Linear Calibration ◽

Component Size ◽

Digital Templating ◽

Total Hip ◽

Implant Size

Abstract Objective Preoperative digital templating is a standard procedure in total hip arthroplasty. Deviations between template size and final implant size may result from inaccurate calibration, templating as well as intraoperative decisions. So far, the explicit effect of calibration errors on templating has not been addressed adequately. Materials and Methods A mathematical simulation of calibration errors up to ± 24% was applied to the templating of acetabular cups (38 to 72 mm diameter). The effect of calibration errors on template component size as deviation from optimal size was calculated. Results The relationship between calibration error and component size deviation is inverse and linear. Calibration errors have a more pronounced effect on larger component sizes. Calibration errors of 2–6% result in templating errors of up to two component sizes. Common errors of up to 12% may result in templating errors of 3–4 sizes for common implant sizes. A tabular matrix visualizes the effect. Conclusion Calibration errors play a significant role in component size selection during digital templating. Orthopedic surgeons should be aware of this effect and try to identify and address this source of error.

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The Accuracy and Ability of Preoperative Templating to Restore Femoral Offset in Calcar-Guided Short-Stem Total Hip Prosthesis through Direct Anterior Approach

The Journal of Hip Surgery ◽

10.1055/s-0041-1729867 ◽

2021 ◽

Author(s):

Barbara Favier ◽

Nathalie van Beek ◽

Mike Tengrootenhuysen

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Anterior Approach ◽

Direct Anterior Approach ◽

Short Stem ◽

Size Difference ◽

Femoral Offset ◽

Stem Size ◽

Total Hip ◽

Preoperative Templating

AbstractThe aim of this study was to assess the applicability and ability of preoperative templating to restore femoral offset and hip length with a calcar-guided short-stem implant design in total hip arthroplasty through the direct anterior approach. Preoperative measurements were performed of femoral offset, hip length, and stem size and compared with the perioperative placed prosthesis in 100 patients undergoing primary total hip replacement through direct anterior approach. Additionally, the pre- and postoperative femoral offset and hip length were compared to evaluate the ability to restore the offset and hip length with this kind of femoral short stem. With an acceptance of 1 size difference pre- and postoperatively, a 94% accuracy of predicting the size of the calcar-guided short stem was achieved with templating. Femoral offset was within means of 5 mm in 82.2% of the patients. Postoperative hip length was within 6 mm in 90% of the patients compared with the preoperative length.The use of preoperative templating for total hip arthroplasty with calcar-guided short-stem implants was proven to be a useful tool to predict the definite implanted size of the femoral prosthesis. Our results show that this new stem design does not significantly differ from previous reported outcomes with other stem designs and is competent to restore the femoral offset and hip length within clinical acceptable range. Level of evidence Level 3 retrospective case study.

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Evaluation of the Accuracy and Use of X-Ray Markers in Digital Templating for Total Hip Arthroplasty

The Journal of Arthroplasty ◽

10.1016/j.arth.2007.11.020 ◽

2009 ◽

Vol 24 (3) ◽

pp. 407-413 ◽

Cited By ~ 22

Author(s):

Christopher O. Bayne ◽

Michael Krosin ◽

Thomas C. Barber

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

X Ray ◽

Digital Templating ◽

Total Hip

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Bone remodelling around the Metha short stem in total hip arthroplasty: a prospective dual-energy X-ray absorptiometry study

International Orthopaedics ◽

10.1007/s00264-011-1361-0 ◽

2011 ◽

Vol 36 (3) ◽

pp. 533-538 ◽

Cited By ~ 72

Author(s):

Matthias Lerch ◽

Annelene von der Haar-Tran ◽

Henning Windhagen ◽

Bernd A. Behrens ◽

Patrick Wefstaedt ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Bone Remodelling ◽

Dual Energy ◽

Short Stem ◽

X Ray ◽

Total Hip

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Templating Hip Arthroplasty

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2019.088 ◽

2019 ◽

Vol 7 (4) ◽

pp. 672-685 ◽

Cited By ~ 1

Author(s):

Amro Alnahhal ◽

Nayef Aslam-Pervez ◽

Hassaan Q. Sheikh

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Reliable Method ◽

Systemic Review ◽

Cochrane Central Register ◽

Digital Templating ◽

Total Hip ◽

Preoperative Templating ◽

Central Register ◽

Implant Size

BACKGROUND: Different methods have been developed and employed with variable degrees of success in pre-operative templating for total hip arthroplasty. Preoperative templating, especially digital templating, has been claimed to have increased the effectiveness of total hip arthroplasty by improving the precision of prediction of prosthetic implant size. AIMS: The overall aim of this systematic review is to identify whether the use of pre-operative templating in total hip arthroplasty procedures has resulted in increased accuracy, reliability and precision of the procedure. Various methods of templating, like traditional acetate overlay and digital method of templating that includes a single radiographic marker and double radiographic marker methods, have been compared to establish the most reliable method of templating. METHODS: We searched the PubMed, Google Scholar Cochrane Central Register of Controlled Trials (CENTRAL), and MEDLINE (1966 to present), EMBASE (1980 to present), CINAHL (1982 to present), Psych INFO (1967 to present) and Clinical Trials Gov. CONCLUSION: The results of this systemic review suggest that preoperative templating is resulting in an enormous increase in the accuracy of total hip arthroplasty and among various methods, King Mark is the most reliable method.

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More than a feeling?—Overruling the preoperatively templated offset option leads to a minor offset increase in short stem total hip arthroplasty

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s00402-021-04331-y ◽

2022 ◽

Author(s):

Matthias Luger ◽

Christian Stadler ◽

Rainer Hochgatterer ◽

Jakob Allerstorfer ◽

Tobias Gotterbarm ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Short Stem ◽

Leg Length ◽

Digital Templating ◽

Stem Size ◽

Total Hip ◽

Press Fit ◽

A Minor ◽

Short Stems

Abstract Purpose Short stems are increasingly used in total hip arthroplasty (THA) because of advantages in bone and soft tissue preservation and reconstruction of hip geometry. Digital templating is essential in determining the correct offset option and stem size in THA. However, the preoperative template sizes might be intraoperatively overruled. Patients and methods We evaluated the effect of intraoperative overruling of the preoperatively templated offset option of a short curved stem on hip offset, leg length, implant positioning, and femoral canal fill index. The overruling was performed in case of intraoperative instability, telescoping, or both. A series of 1052 consecutive THAs with a cementless short curved stem and press-fit cup was retrospectively screened. One hundred patients with unilateral THA and a contralateral native and morphologically healthy hip as a reference met the inclusion criteria. Measurements were carried out on preoperative and 3 months anterior–posterior postoperative radiographs. Patients were divided according to the overruling by offset option or stem size. Results Hip offset was increased in all groups, but only with significant increase if an offset option + 1 was used intraoperatively (p = 0.025). LLD was restored without significance in all groups (p = 0.323; p = 0.157). Conclusion Intraoperative overruling of the preoperative digital template in cementless short stem total hip arthroplasty results in an increase of hip offset compared to a contralateral healthy hip. However, the increase is marginal and clearly under 5 mm compared to the contralateral healthy hip.

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