scholarly journals Digital templating in total hip arthroplasty using contralateral healthy hip results in decreased accuracy

2021 ◽  
Vol 87 (3) ◽  
pp. 427-433
Author(s):  
Ittai Shichman ◽  
Or Shaked ◽  
Samuel Morgan ◽  
Simon Garceau ◽  
Nimrod Snir ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Joint ◽  
Hip Arthroplasty ◽  
Femoral Stem ◽  
Contralateral Side ◽  
Acetabular Cup ◽  
Component Size ◽  
Digital Templating ◽  
Total Hip ◽  
Healthy Side

The accuracy of pre-operative digital templating for total hip arthroplasty (THA) using the diseased versus unaffected contralateral joint remains unclear. As such, we devised a study to compare templating precision between the operated hip joint versus the healthy side for patients with osteoarthritis (OA). The study hypothesis was that preoperative templating accuracy of THA on the ipsilateral diseased hip joint would be higher compared to the contralateral healthy hip in patients with OA. We retrospectively reviewed 100 patients who underwent THA for unilateral OA at our center from January 2018 to January 2020. Retrospective preoperative digital templating was performed separately on both the operated hip joint and the healthy contralateral hip joint by a single surgeon who was blinded by the in-situ components sizes. Accuracy of each group was compared to the implanted components. Assessment of the 100 included cases demonstrated superior acetabular component size prediction when templating was performed using the diseased hip compared to the healthy contralateral side (68.0% versus 51.0%, p<0.001). No differences between the cohorts were found regarding templating accuracy of femoral stem sizes (72.0% and 69.0%, p=0.375) or neck offset (73.0% and 69.0%, p=0.289). Templating acetabular cup size using the ipsilateral diseased hip is more accurate than using the contralateral healthy hip in patients with unilateral OA.

scholarly journals Value of 3D Preoperative Planning for Primary Total Hip Arthroplasty Based on Artificial Intelligence Technology

2020 ◽  
Author(s):  
Jiabang Huo ◽  
Guangxin Huang ◽  
Dong Han ◽  
Xinjie Wang ◽  
Yufan Bu ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Acetabular Dysplasia ◽  
Preoperative Planning ◽  
Femoral Stem ◽  
Acetabular Cup ◽  
Component Size ◽  
Total Hip ◽  
Digital Template

Abstract Background: Accurate preoperative planning is an important step for accurate reconstruction in total hip arthroplasty (THA). Presently, preoperative planning is completed using either a two-dimensional (2D) template or three-dimensional (3D) mimics software. With the development of artificial intelligence (AI) technology, AI HIP, a planning software based on AI technology can quickly and automatically identify acetabular and femur morphology, and automatically match the optimal prosthesis size. However, the accuracy and feasibility of its clinical application still needs to be further verified. The purposes of this study were to investigate the accuracy and time efficiency of AI HIP in preoperative planning for primary THA, compared with 3D mimics software and 2D digital template; and further analyze the factors that influence the accuracy of AI HIP.Methods: A prospective study was conducted on 53 consecutive patients (59 hips) undergoing primary THA with cementless prostheses in our department. All preoperative planning was completed using AI HIP as well as 3D mimics and 2D digital template. The predicted component size and the actual implantation results were compared to determine the accuracy. The templating time was compared to determine the efficiency. Furthermore, the potential factors influencing the accuracy of AI HIP were analyzed including sex, body mass index (BMI), and hip dysplasia.Results: The accuracy in predicting the acetabular cup and femoral stem was 74.58% and 71.19%, respectively, for AI HIP; 71.19% (P = 0.743) and 76.27% (P = 0.468), respectively, for 3D mimics; 40.68% (P < 0.001) and 49.15% (P = 0.021), respectively, for 2D digital templating. The templating time using AI HIP was 3.91±0.64 min, which was equivalent to 2D digital templates (2.96±0.48 min, P < 0.001), but shorter than 3D mimics (32.07±2.41 min, P < 0.001). Acetabular dysplasia(P = 0.021), rather than sex and BMI, was an influential factor in the accuracy of AI HIP templating. Compared to patients with developmental dysplasia of the hip (DDH), the accuracy of acetabular cup in the non-DDH group was better (P = 0.021), but the difference in the accuracy of the femoral stem between the two groups was statistically insignificant (P = 0.062).Conclusion: AI HIP showed excellent reliability for component size in THA. Acetabular dysplasia may affect the accuracy of AI HIP templating.

scholarly journals The accuracy of digital templating in cementless total hip arthroplasty in dysplastic hips

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Emelie Kristoffersson ◽  
Volker Otten ◽  
Sead Crnalic
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Femoral Stem ◽  
Developmental Dysplasia ◽  
Leg Length ◽  
Acetabular Cup ◽  
Digital Templating ◽  
Total Hip ◽  
Implant Size ◽  
Crowe Classification

Abstract Background Total hip arthroplasty (THA) for developmental dysplasia of the hip (DDH) is a complex procedure due to associated anatomical abnormalities. We studied the extent to which preoperative digital templating is reliable when performing cementless THA in patients with DDH. Methods We templated and compared the pre- and postoperative sizes of the acetabular and femoral components and the center of rotation (COR), and analysed the postoperative cup coverage, leg length discrepancy (LLD), and stem alignment in 50 patients (56 hips) with DDH treated with THA. Results The implant size exactly matched the template size in 42.9% of cases for the acetabular component and in 38.2% of cases for the femoral component, whereas the templated ±1 size was used in 80.4 and 81.8% of cases for the acetabular and femoral components, respectively. There were no statistically significant differences between templated and used component sizes among different DDH severity levels (acetabular cup: p = 0.30 under the Crowe classification and p = 0.94 under the Hartofilakidis classification; femoral stem: p = 0.98 and p = 0.74, respectively). There were no statistically significant differences between the planned and postoperative COR (p = 0.14 horizontally and p = 0.52 vertically). The median postoperative LLD was 7 (range 0–37) mm. Conclusion Digital preoperative templating is reliable in the planning of cementless THA in patients with DDH.

scholarly journals Value of 3D Preoperative Planning for Primary Total Hip Arthroplasty Based on Artificial Intelligence Technology

2021 ◽  
Author(s):  
Jiabang Huo ◽  
Guangxin Huang ◽  
Dong Han ◽  
Xinjie Wang ◽  
Yufan Bu ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Acetabular Dysplasia ◽  
Preoperative Planning ◽  
Femoral Stem ◽  
Acetabular Cup ◽  
Component Size ◽  
Total Hip ◽  
Digital Template

Abstract Background: Accurate preoperative planning is an important step for accurate reconstruction in total hip arthroplasty (THA). Presently, preoperative planning is completed using either a two-dimensional (2D) template or three-dimensional (3D) mimics software. With the development of artificial intelligence (AI) technology, AI HIP, a planning software based on AI technology can quickly and automatically identify acetabular and femur morphology, and automatically match the optimal prosthesis size. However, the accuracy and feasibility of its clinical application still needs to be further verified. The purposes of this study were to investigate the accuracy and time efficiency of AI HIP in preoperative planning for primary THA, compared with 3D mimics software and 2D digital template; and further analyze the factors that influence the accuracy of AI HIP.Methods: A prospective study was conducted on 53 consecutive patients (59 hips) undergoing primary THA with cementless prostheses in our department. All preoperative planning was completed using AI HIP as well as 3D mimics and 2D digital template. The predicted component size and the actual implantation results were compared to determine the accuracy. The templating time was compared to determine the efficiency. Furthermore, the potential factors influencing the accuracy of AI HIP were analyzed including sex, body mass index (BMI), and hip dysplasia.Results: The accuracy of predicting the size of acetabular cup and femoral stem was 74.58% and 71.19%, respectively, for AI HIP; 71.19% (P = 0.743) and 76.27% (P = 0.468), respectively, for 3D mimics; 40.68% (P < 0.001) and 49.15% (P = 0.021), respectively, for 2D digital templating. The templating time using AI HIP was 3.91±0.64 min, which was equivalent to 2D digital templates (2.96±0.48 min, P < 0.001), but shorter than 3D mimics (32.07±2.41 min, P < 0.001). Acetabular dysplasia(P = 0.021), rather than sex and BMI, was an influential factor in the accuracy of AI HIP templating. Compared to patients with developmental dysplasia of the hip (DDH), the accuracy of acetabular cup in the non-DDH group was better (P = 0.021), but the difference in the accuracy of the femoral stem between the two groups was statistically insignificant (P = 0.062).Conclusion: AI HIP showed excellent reliability for component size in THA. Acetabular dysplasia may affect the accuracy of AI HIP templating.

scholarly journals Value of 3D preoperative planning for primary total hip arthroplasty based on artificial intelligence technology

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Jiabang Huo ◽  
Guangxin Huang ◽  
Dong Han ◽  
Xinjie Wang ◽  
Yufan Bu ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Acetabular Dysplasia ◽  
Preoperative Planning ◽  
Femoral Stem ◽  
Acetabular Cup ◽  
Component Size ◽  
Total Hip ◽  
Digital Template

Abstract Background Accurate preoperative planning is an important step for accurate reconstruction in total hip arthroplasty (THA). Presently, preoperative planning is completed using either a two-dimensional (2D) template or three-dimensional (3D) mimics software. With the development of artificial intelligence (AI) technology, AI HIP, a planning software based on AI technology, can quickly and automatically identify acetabular and femur morphology, and automatically match the optimal prosthesis size. However, the accuracy and feasibility of its clinical application still needs to be further verified. The purposes of this study were to investigate the accuracy and time efficiency of AI HIP in preoperative planning for primary THA, compared with 3D mimics software and 2D digital template, and further analyze the factors that influence the accuracy of AI HIP. Methods A prospective study was conducted on 53 consecutive patients (59 hips) undergoing primary THA with cementless prostheses in our department. All preoperative planning was completed using AI HIP as well as 3D mimics and 2D digital template. The predicted component size and the actual implantation results were compared to determine the accuracy. The templating time was compared to determine the efficiency. Furthermore, the potential factors influencing the accuracy of AI HIP were analyzed including sex, body mass index (BMI), and hip dysplasia. Results The accuracy of predicting the size of acetabular cup and femoral stem was 74.58% and 71.19%, respectively, for AI HIP; 71.19% (P = 0.743) and 76.27% (P = 0.468), respectively, for 3D mimics; and 40.68% (P < 0.001) and 49.15% (P = 0.021), respectively, for 2D digital templating. The templating time using AI HIP was 3.91 ± 0.64 min, which was equivalent to 2D digital templates (2.96 ± 0.48 min, P < 0.001), but shorter than 3D mimics (32.07 ± 2.41 min, P < 0.001). Acetabular dysplasia (P = 0.021), rather than sex and BMI, was an influential factor in the accuracy of AI HIP templating. Compared to patients with developmental dysplasia of the hip (DDH), the accuracy of acetabular cup in the non-DDH group was better (P = 0.021), but the difference in the accuracy of the femoral stem between the two groups was statistically insignificant (P = 0.062). Conclusion AI HIP showed excellent reliability for component size in THA. Acetabular dysplasia may affect the accuracy of AI HIP templating.

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

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.

scholarly journals The Utility of Digital Linear Tomosynthesis Imaging of Total Hip Joint Arthroplasty with Suspicion of Loosening: A Prospective Study in 40 Patients

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Jan H. Göthlin ◽  
Mats Geijer
Keyword(s):  
Total Hip Arthroplasty ◽  
Prospective Study ◽  
Hip Joint ◽  
Hip Arthroplasty ◽  
Clinical Utility ◽  
Hip Prosthesis ◽  
Joint Arthroplasty ◽  
Acetabular Cup ◽  
Total Hip ◽  
A Prospective Study

Aim. The clinical utility of digital linear tomosynthesis in musculoskeletal applications has been validated in only a few reports. Technical performance and utility in hip prosthesis imaging have been discussed in technical reports, but no clinical evaluation has been reported. The purpose of the current study was to assess the added clinical utility of digital linear tomosynthesis compared to radiography in loosening of total hip joint arthroplasty.Materials and Methods. In a prospective study, radiography and digital tomosynthesis were performed in 40 consecutive patients with total hip arthroplasty referred for suspect prosthesis loosening. Tomosynthesis images were compared to anterior-posterior (AP) and cross-table lateral radiographs regarding demarcation and extent of demineralization and osteolysis. Further noted were skeletal fractures, cement fractures, fragmentation, and artifacts interfering with the diagnosis.Results. Tomosynthesis was superior to radiography with sharper delineation of demineralization and osteolysis in the AP projection. A limitation was the inability to generate lateral tomosynthesis images, with inferior assessment of the area anterior and posterior to the acetabular cup compared to cross-table radiographs. Artifacts interfering with diagnosis were found in one hip.Conclusion. Tomosynthesis improved evaluation of total hip arthroplasty in the AP projection but was limited by the lack of lateral projections.

scholarly journals Long-Term results of total Hip Arthroplasty performed using a cementless expansive Acetabular Cup and Spotorno Femoral Stem

2020 ◽  
Vol 37 (1) ◽  
Author(s):  
Engin Çarkçı ◽  
Ayse Esin Polat ◽  
Yusuf Öztürkmen ◽  
Tolga Tüzüner
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Survival Rates ◽  
Femoral Stem ◽  
Long Term Results ◽  
Harris Hip Score ◽  
Acetabular Cup ◽  
Total Hip ◽  
Kaplan Meier

Objective: In this study we aimed to investigate the long-term clinical and radiological results, revision rates and causes, and the rate of implant survival in total hip arthroplasty performed using CLS® expansion cup and Spotorno® cementless femoral stem. Methods: Clinical results of total hip arthroplasty performed on 131 hips of 114 patients in Istanbul Training and Research Hospital between 1993 and 2003 were retrospectively evaluated according to the Harris Hip Score. Revision rates were determined and implant survival rates were identified using the Kaplan-Meier estimator. Results: Of the patients, 39 were males and 75 were females. The average age of the patients at surgery was 48.7±11.3 years. Patients were followed up for a mean period of 13.9±2.4 years. The mean Harris Hip Score was 34.35±6.09 preoperatively and 88.20±7.11 at the final follow-up (p<0.001). The Kaplan-Meier survivorship estimate for the cup at 13.9 years, taking revision for any reason as the end point was 95.6% (95% CI), while the 15th and 17th year survival rates were 90% and 85%, respectively. Conclusion: In total hip arthroplasty using a cementless expansive acetabular cup, a 95.6% survival rate is achieved after an average of 14 years, whereas the rate decreases to 85% after 17 years. Even if the incidence of cup breakage is reduced with proper implantation, particle disease and periacetabular osteolysis remains a problem for the long-term survival. doi: https://doi.org/10.12669/pjms.37.1.3089 How to cite this:Carkci E, Polat AE, Ozturkmen Y, Tuzuner T. Long-Term results of total Hip Arthroplasty performed using a cementless expansive Acetabular Cup and Spotorno Femoral Stem. Pak J Med Sci. 2021;37(1):52-58. doi: https://doi.org/10.12669/pjms.37.1.3089 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Leg lengthening and femoral-offset reduction after total hip arthroplasty: where is the problem – stem or cup positioning?

2017 ◽  
Vol 58 (9) ◽  
pp. 1125-1131 ◽  
Author(s):  
Bariq Al-Amiry ◽  
Sarwar Mahmood ◽  
Ferid Krupic ◽  
Arkan Sayed-Noor
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Femoral Stem ◽  
Contralateral Side ◽  
Leg Length ◽  
Acetabular Cup ◽  
Femoral Offset ◽  
Leg Lengthening ◽  
Observer Reliability ◽  
Cup Positioning

Background Restoration of femoral offset (FO) and leg length is an important goal in total hip arthroplasty (THA) as it improves functional outcome. Purpose To analyze whether the problem of postoperative leg lengthening and FO reduction is related to the femoral stem or acetabular cup positioning or both. Material and Methods Between September 2010 and April 2013, 172 patients with unilateral primary osteoarthritis treated with THA were included. Postoperative leg-length discrepancy (LLD) and global FO (summation of cup and FO) were measured by two observers using a standardized protocol for evaluation of antero-posterior plain hip radiographs. Patients with postoperative leg lengthening ≥10 mm (n = 41) or with reduced global FO >5 mm (n = 58) were further studied by comparing the stem and cup length of the operated side with the contralateral side in the lengthening group, and by comparing the stem and cup offset of the operated side with the contralateral side in the FO reduction group. We evaluated also the inter-observer and intra-observer reliability of the radiological measurements. Results Both observers found that leg lengthening was related to the stem positioning while FO reduction was related to the positioning of both the femoral stem and acetabular cup. Both inter-observer reliability and intra-observer reproducibility were moderate to excellent (intra-class correlation co-efficient, ICC ≥0.69). Conclusion Post THA leg lengthening was mainly caused by improper femoral stem positioning while global FO reduction resulted from improper positioning of both the femoral stem and the acetabular cup.

Does total hip arthroplasty with high hip centre in dysplasia compromise acetabular bone stock?

2021 ◽  
pp. 112070002110594
Author(s):  
Arun Kannan ◽  
Chameka Madurawe ◽  
Jim Pierrepont ◽  
Stephen McMahon
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Young Patients ◽  
Host Bone ◽  
Bone Stock ◽  
Acetabular Cup ◽  
Digital Templating ◽  
3 Dimensional ◽  
Total Hip ◽  
The Mean

Background: The placement of uncemented acetabular components during total hip arthroplasty (THA) in Crowe II and Crowe III dysplasia can be at the anatomic or high hip centre position. Purposes: Using computerised tomography data, we simulated acetabular cup placement at the anatomic hip centre and the high hip centre positions to assess whether there is a difference between the 2 in terms of bone loss from acetabular reaming and in acetabular coverage by host bone. Methods: The study population included a consecutive cohort of 19 patients (22 hips) with Crowe II or III dysplasia. 3-dimensional models of the pelvis were created for each patient and digital templating was used to determine the anatomic and high hip centre positions. The coordinates of the digitally templated cup positions were fed into an image processing software to estimate the amount of bone reamed, the cup coverage by host bone and the elevation from tear drop. Results: The mean volume of bone reamed was greater in the high hip centre position as compared to the anatomic position (27.3 ± 11. 4 cm3 vs. 19.4 ± 12.2 cm3, p  < 0.0001). The coverage of the acetabular cup by host bone was greater in the high hip centre position (87.3 ± 5.9% vs. 68.3 ± 10%). The mean elevation in the high hip centre group was 13 mm with 3 hips having a breach of the medial wall. Conclusions: In Crowe II and III dysplasia, placement of acetabular cups at the anatomic hip centre better preserves bone stock as compared to high hip centre placement and should be preferred in young patients requiring THA.

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