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A novel calibration method for digital templating of total hip arthroplasty: a prospective clinical study of dual scale type single marker calibration in supine radiographs

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Abstract

Background

External calibration markers (ECM) are the standard of care for digital templating in joint replacements. Spherical mono markers are known to be unreliable. Fixed calibration factors (FCF) can reduce the overall error by placement of markers, but do not address individual patient anatomy. Dual scale calibration marker (DSCM) methods were developed to improve precision of calibration but require two markers. This prospective observational study is the first to analyse the application of a dual scale type single marker (DSSM) method in supine radiographs.

Methods

One hundred patients with unilateral total hip arthroplasty (THA) underwent anterior-posterior pelvis X-ray with ECM and DSSM. The femoral THA head components were used as internal reference (ICM). An empirical fixed calibration factor (FCF; 120%) was used as comparator. Absolute differences of ICM and both ECM and DSSM were calculated. Absolute relative deviations (ARD) were calculated.

Results

Mean absolute calibration factor differences of ECM, FCF and DSSM from ICM were 0.105 (0.002–0.182), 0.016 (0.082–0.013) and 0.011 (0.056–0.009), respectively. ARD differences between ECM and DSSM as well as FCF and DSSM were significant (p < 0.001).

Conclusion

The DSSM method showed superior results over ECM and FCF to predict the optimal calibration factor in supine radiographs. The novel DSSM method could be used to improve digital templating in supine radiographs without need for additional markers.

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Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery and Traumatology, St. Josefs Hospital Wiesbaden, Wiesbaden, Germany

    Lennard Loweg & Karl Philipp Kutzner

  2. Department of Orthopaedics and Traumatology, St. Josef-Hospital, Ruhr University Bochum, Bochum, Germany

    Matthias Trost

  3. Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Christian Ries

  4. Department of Orthopaedic and Trauma Surgery, University Hospital of Cologne, Joseph-Stelzmann-Str. 9, 50924, Cologne, Germany

    Christoph Kolja Boese

Authors
  1. Lennard Loweg
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  2. Matthias Trost
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  3. Karl Philipp Kutzner
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  4. Christian Ries
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  5. Christoph Kolja Boese
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Contributions

LL organized and performed the study, enrolled patients, collected data, performed measurements, and reviewed the manuscript.

MT critically reviewed the manuscript.

KPK critically reviewed the manuscript.

CR critically reviewed the manuscript and created artwork.

CKB conceived and designed the study, performed the analysis, and wrote the manuscript.

Corresponding author

Correspondence to Christoph Kolja Boese.

Ethics declarations

The study was approved by the responsible ethics committee (FF 75/2018). All patients gave their informed consent. The most recent version of the Declaration of Helsinki was followed.

Conflict of interest

CKB is employee of Smith & Nephew GmbH. The other authors did not report any conflicting interests.

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Loweg, L., Trost, M., Kutzner, K.P. et al. A novel calibration method for digital templating of total hip arthroplasty: a prospective clinical study of dual scale type single marker calibration in supine radiographs. International Orthopaedics (SICOT) 44, 1693–1699 (2020). https://doi.org/10.1007/s00264-020-04597-8

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  • DOI: https://doi.org/10.1007/s00264-020-04597-8

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