Hip & pelvis

The Korean Hip Society (대한고관절학회)
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Surgeon's Experience and Accuracy of Preoperative Digital Templating in Primary Total Hip Arthroplasty

  • Maria Surroca (Hip Unit, Department of Orthopedic Surgery, Fundacio Assistencial Mutua Terrassa) ;
  • Silvia Miguela (Hip Unit, Department of Orthopedic Surgery, Fundacio Assistencial Mutua Terrassa) ;
  • Agusti Bartra-Ylla (Hip Unit, Department of Orthopedic Surgery, Fundacio Assistencial Mutua Terrassa) ;
  • Jorge H. Nunez (Hip Unit, Department of Orthopedic Surgery, Fundacio Assistencial Mutua Terrassa) ;
  • Francesc Angles-Crespo (Hip Unit, Department of Orthopedic Surgery, Fundacio Assistencial Mutua Terrassa)
  • Received : 2023.08.08
  • Accepted : 2023.12.22
  • Published : 2024.06.01
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Abstract

Purpose: Preoperative planning has become essential in performance of total hip arthroplasty (THA). However, data regarding the effect of the planner's experience on the accuracy of digital preoperative planning is limited. The objective of this study was to assess the accuracy of digital templating in THA based on the surgeon's experience. Materials and Methods: A retrospective study was conducted. An analysis of 98 anteroposterior pelvic radiographs, which were individually templated by four surgeons (two hip surgeons and two orthopaedic residents) using TraumaCad® digital planning, was performed. A comparison of preoperatively planned sizes with implanted sizes was performed to evaluate the accuracy of predicting component size. The results of preoperative planning performed by hip surgeons and orthopaedic residents were compared for testing of the planner's experience. Results: Femoral stem was precisely predicted in 32.4% of cases, acetabular component in 40.3%, and femoral offset in 76.7%. Prediction of cup size showed greater accuracy than femoral size among all observers. No differences in any variable were observed among the four groups (acetabular cup P=0.07, femoral stem P=0.82, femoral offset P=0.06). All measurements showed good reliability (intraclass correlation coefficient [ICC] acetabular cup: 0.76, ICC femoral stem: 0.79). Conclusion: The results of this study might suggest that even though a surgeon's experience supports improved precision during the planning stage, it should not be restricted only to surgeons with a high level of experience. We consider preoperative planning an essential part of the surgery, which should be included in training for orthopaedics residents.

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References

  1. Khanduja V. Total hip arthroplasty in 2017 - current concepts and recent advances. Indian J Orthop. 2017;51:357-8. https://doi.org/10.4103/ortho.IJOrtho_367_17
  2. Liu XW, Zi Y, Xiang LB, Wang Y. Total hip arthroplasty: a review of advances, advantages and limitations. Int J Clin Exp Med. 2015;8:27-36.
  3. Smith JBV, Bishi H, Wang C, Asopa V, Field RE, Sochart DH. The accuracy and reliability of preoperative digital 2D templating in prosthesis size prediction in uncemented versus cemented total hip arthroplasty: a systematic review and meta-analysis. EFORT Open Rev. 2021;6:1020-39. https://doi.org/10.1302/2058-5241.6.210048
  4. Alnahhal A, Aslam-Pervez N, Sheikh HQ. Templating hip arthroplasty. Open Access Maced J Med Sci. 2019;7:672-85. https://doi.org/10.3889/oamjms.2019.088
  5. Efe T, El Zayat BF, Heyse TJ, Timmesfeld N, Fuchs-Winkelmann S, Schmitt J. Precision of preoperative digital templating in total hip arthroplasty. Acta Orthop Belg. 2011;77:616-21.
  6. Blackley HR, Howell GE, Rorabeck CH. Planning and management of the difficult primary hip replacement: preoperative planning and technical considerations. Instr Course Lect. 2000;49:3-11.
  7. Gonzalez Della Valle A, Comba F, Taveras N, Salvati EA. The utility and precision of analogue and digital preoperative planning for total hip arthroplasty. Int Orthop. 2008;32:289-94. https://doi.org/10.1007/s00264-006-0317-2
  8. Gonzalez Della Valle A, Slullitel G, Piccaluga F, Salvati EA. The precision and usefulness of preoperative planning for cemented and hybrid primary total hip arthroplasty. J Arthroplasty. 2005;20:51-8. https://doi.org/10.1016/j.arth.2004.04.016
  9. Xu S, Lim JBT, Pang HN. Improving acetabular component positioning in supine direct anterior total hip arthroplasty with a transparency template: a novel, simple, and cost-effective technique. Hip Pelvis. 2021;33:120-7. https://doi.org/10.5371/hp.2021.33.3.120
  10. Montiel V, Troncoso S, Valenti-Azcarate A, Valenti-Nin JR, Lamo-Espinosa JM. Total hip arthroplasty digital templating: size predicting ability and interobserver variability. Indian J Orthop. 2020;54:840-7. https://doi.org/10.1007/s43465-020-00217-0
  11. Petretta R, Strelzow J, Ohly NE, Misur P, Masri BA. Acetate templating on digital images is more accurate than computer-based templating for total hip arthroplasty. Clin Orthop Relat Res. 2015;473:3752-9. https://doi.org/10.1007/s11999-015-4321-y
  12. Bertz A, Indrekvam K, Ahmed M, Englund E, Sayed-Noor AS. Validity and reliability of preoperative templating in total hip arthroplasty using a digital templating system. Skeletal Radiol. 2012;41:1245-9. https://doi.org/10.1007/s00256-012-1431-4
  13. Eschweiler J, Fieten L, Dell'Anna J, et al. Application and evaluation of biomechanical models and scores for the planning of total hip arthroplasty. Proc Inst Mech Eng H. 2012;226:955-67. https://doi.org/10.1177/0954411912445261
  14. Colombi A, Schena D, Castelli CC. Total hip arthroplasty planning. EFORT Open Rev. 2019;4:626-32. https://doi.org/10.1302/2058-5241.4.180075
  15. Kearney R, Shaikh AH, O'Byrne JM. The accuracy and inter-observer reliability of acetate templating in total hip arthroplasty. Ir J Med Sci. 2013;182:409-14. https://doi.org/10.1007/s11845-013-0901-6
  16. Shin JK, Son SM, Kim TW, Shin WC, Lee JS, Suh KT. Accuracy and reliability of preoperative on-screen templating using digital radiographs for total hip arthroplasty. Hip Pelvis. 2016;28:201-7. https://doi.org/10.5371/hp.2016.28.4.201
  17. Hsu AR, Kim JD, Bhatia S, Levine BR. Effect of training level on accuracy of digital templating in primary total hip and knee arthroplasty. Orthopedics. 2012;35:e179-83. https://doi.org/10.3928/01477447-20120123-15
  18. Kumar PG, Kirmani SJ, Humberg H, Kavarthapu V, Li P. Reproducibility and accuracy of templating uncemented THA with digital radiographic and digital TraumaCad templating software. Orthopedics. 2009;32:815. https://doi.org/10.3928/01477447-20090922-08
  19. Mittag F, Ipach I, Schaefer R, Meisner C, Leichtle U. Predictive value of preoperative digital templating in THA depends on the surgical experience of the performing physician. Orthopedics. 2012;35:e144-7. https://doi.org/10.3928/01477447-20120123-14
  20. Holzer LA, Scholler G, Wagner S, Friesenbichler J, Maurer-Ertl W, Leithner A. The accuracy of digital templating in un-cemented total hip arthroplasty. Arch Orthop Trauma Surg. 2019;139:263-8. https://doi.org/10.1007/s00402-018-3080-0
  21. Jung S, Neuerburg C, Kappe T, Wernerus D, Reichel H, Bieger R. [Validity of digital templating in total hip arthroplasty: impact of stem design and planner's experience]. Z Orthop Unfall. 2012;150:404-8. German. https://doi.org/10.1055/s-0031-1298386
  22. Osmani FA, Thakkar S, Ramme A, Elbuluk A, Wojack P, Vigdorchik JM. Variance in predicted cup size by 2-dimensional vs 3-dimensional computerized tomography-based templating in primary total hip arthroplasty. Arthroplast Today. 2017;3:289-93. https://doi.org/10.1016/j.artd.2016.09.003
  23. Wako Y, Nakamura J, Miura M, Kawarai Y, Sugano M, Nawata K. Interobserver and intraobserver reliability of three-dimensional preoperative planning software in total hip arthroplasty. J Arthroplasty. 2018;33:601-7. https://doi.org/10.1016/j.arth.2017.08.031
  24. Kuroda K, Kabata T, Maeda T, et al. The value of computed tomography based navigation in revision total hip arthroplasty. Int Orthop. 2014;38:711-6. https://doi.org/10.1007/s00264-013-2166-0