Use of Acetate Templates Over Digital Radiographs for Templating in Total Hip Arthroplasty: Technique and Its Validation
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ORIGINAL ARTICLE
Use of Acetate Templates Over Digital Radiographs for Templating in Total Hip Arthroplasty: Technique and Its Validation Tarun Goyal1 · Siddharth S. Sethy2 · Sajid Ansari2 · Lakshmana Das2 · Souvik Paul2 Received: 28 August 2020 / Accepted: 21 October 2020 © Indian Orthopaedics Association 2020
Abstract Purpose Acetate templates were commonly used for templating for total hip arthroplasty. With digital radiographs having replaced conventional analogue radiographs, newer techniques are required. We describe a method for templating images of digital radiographs using conventional acetate templates, which is independent of a magnification marker or PACS system. Methods Fifty-one patients (64 hips) who were treated with primary THA were prospectively evaluated. Templating was done by keeping the acetate template directly over the digital image of the radiograph on a liquid crystal display (LCD) monitor, after calibrating the linear scale generated by the digital radiography machine. The size of prosthesis predicted on this templating technique was compared with the actual sizes used during the surgery. Inter-observer and intra-observer reliabilities were assessed. Our calibration method was further validated by comparing the size of the cup calculated on postoperative radiograph using digital templating software (mediCAD Hectec GmbH) and the actual size used during surgery. Results Accurate size was predicted for 36.7% of the acetabular cup and 35.9% of femoral stems. The accuracy within ± one size was 89.9% for acetabular cups and 91.4% for femoral stems. Excellent inter-observer and intra-observer reliability were seen for both femoral and acetabular components. Conclusion The method described provides an accurate, reproducible, convenient and low-cost technique of preoperative templating. It combines the ease of using acetate templates with the convenience of being able to use digital images, without the need for expensive software. Keywords Digital radiograph · Templating · Total hip arthroplasty
Introduction
* Tarun Goyal [email protected] Siddharth S. Sethy [email protected] Sajid Ansari [email protected] Lakshmana Das [email protected] Souvik Paul [email protected] 1
Department of Orthopaedics, All India Institute of Medical Sciences, Bathinda, Punjab 151001, India
Department of Orthopaedics, All India Institute of Medical Sciences, Rishikesh, India
2
Total hip arthroplasty (THA) is a common procedure for relieving pain and improving function in patients having significant hip arthritis. Complications like peri-prosthetic fractures, prosthetic loosening, loss of bone stock and impingement can occur if components are incorrectly sized [1–3]. Preoperative templating using radiographs could avoid such complications [4–7]. Another important purpose of templating is to get a fair idea regarding the acetabular cup and femoral stem size in advance and anticipating the need for uncommon components that may not be readily available. Restoration of offset
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