Total Hip Arthroplasty Digital Templating: Size Predicting Ability and Interobserver Variability
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ORIGINAL ARTICLE
Total Hip Arthroplasty Digital Templating: Size Predicting Ability and Interobserver Variability Veronica Montiel1 · Santiago Troncoso1 · Andrés Valentí‑Azcárate1 · Juan Ramón Valentí‑Nin1 · Jose María Lamo‑Espinosa1 Received: 16 July 2020 / Accepted: 23 July 2020 / Published online: 3 August 2020 © Indian Orthopaedics Association 2020
Abstract Background During the last century, total hip arthroplasties have become more popular. They have had a huge impact on the quality of life, pain, range of motion, social interaction, and psychological well-being. A number of studies have emphasized the importance of using templates to choose the appropriate implant size when planning the surgery. Our aim is to use MediCad® software to analyze the ability of the digital template system MediCad® to predict the size of the implant needed in total hip arthroplasties. Materials and Methods An arthroplasty preoperative plan was created according to the M ediCad® software guidelines, on anteroposterior hip X-ray by one junior resident, one senior resident, and three experienced hip surgeons. Results The median size accuracy was 0.7 (range: 0.27–0.87) for the cup, 0.73 (range: 0.36–0.83) for the stem, and 0.28 (range: −0.14–0.69) for the neck. Interobserver reliability was good (kappa > 0.4) and stronger when measuring the stem than when doing so with the cup. Conclusion: Digital preoperative total hip arthroplasty planning is a good method for predicting component size, restoring hip anatomy (vertical offset and horizontal offset), with good interobserver reliability. Keywords Digital templating · Hip arthroplasty · Total hip arthroplasty · Total hip arthroplasty preoperative planning
Introduction Total hip arthroplasties (THAs) are one of the greatest medical innovations of the 20th century [1], due to their impact upon the quality of life, pain, range of motion, social interaction, and psychological well-being [2]. Good long term results encourage performing total hip replacements at earlier ages to achieve an active lifestyle after the procedure with the greatest possible implant survival. Obtaining excellent radiological results has hence become imperative. Therefore, a good preoperative plan of implants’ size and position should be done. Furthermore, using these templates, the risks associated with potential complications such as periprosthetic fractures, the inappropriate difference in leg length, and dislocation are decreased, leading to higher implant survival rates and less implant wear. * Veronica Montiel [email protected] 1
Department of Orthopedic Surgery and Traumatology, Clínica Universidad de Navarra, Av. Pio XII, 36, 31008 Pamplona, Navarra, Spain
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During the past two decades, digital image acquisition and reviewing have become widespread, and with it, digital templating is becoming more and more popular. These digital templates are 15%–20% [3] magnified, and according to Conn et al., they are only accurate in 65% of the cases [4]. Most studies consider their fina
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