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Accuracy of two-dimensional digital planning in uncemented primary hip arthroplasty: monocentric analysis of eight hundred implants

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Abstract

Purpose

In the last decades, there has been a refinement in total hip arthroplasty, which allowed surgeons to achieve the highest performance and better patient outcomes. Preoperative planning in primary hip arthroplasty is an essential step that guides the surgeon in restoring the anatomy and biomechanics of the joint. This study aims to evaluate the accuracy of the 2D digital planning, considering cup sizing, stem sizing, and limb length discrepancy. Additionally, we conducted a multivariable analysis of demographic data and comorbidities to find factors influencing preoperative planning.

Methods

This retrospective study analyzed the planning accuracy in 800 consecutive uncemented primary total hip arthroplasty. We compared the preoperatively planned total hip arthroplasty with postoperative results regarding the planned component size, the implanted size, and the lower limb length restoration. Therefore, we investigated factors influencing planning accuracy: overweight and obesity, sex, age, past medical history, comorbidities, and implant design. All the surgeries were performed in the posterolateral approach by one expert surgeon who did the preoperative planning. The preoperative planning was determined to be (a) exact if the planned and the implanted components were the same size and (b) accurate if exact ± one size. The restoration of postoperative limb length discrepancy was classified into three groups: ± 3 mm, ± 5 mm, and ± 10 mm. This assessment was performed through a digital method 2D based on a standard hip X-ray.

Results

This court of 800 implants showed that planning was exact in 60% of the cups and 44% of the stems and was accurate in 94% of the cups and 80% of the stems. The postoperative limb length discrepancy was ± 3 mm in 91% and ± 5 mm in 97%.

Conclusions

This study showed preoperative 2D digital planning great precision and reliability, and we demonstrated that it was accurate in 94% of the cups and 80% of the stems. Therefore, the preoperative limb length discrepancy analysis was essential to guarantee the recovery of the operated limb’s correct length.

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Author information

Authors and Affiliations

  1. Department of Orthopaedic and Trauma Surgery, Università Campus Bio-Medico Di Roma, Rome, Italy

    Biagio Zampogna, Francesco Rosario Parisi, Andrea Zampoli, Anna Prezioso, Ferruccio Vorini, Nicola Papapietro & Rocco Papalia

  2. Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy

    Biagio Zampogna, Francesco Rosario Parisi, Andrea Zampoli, Anna Prezioso, Ferruccio Vorini, Nicola Papapietro & Rocco Papalia

  3. Department of Medicine, Research Unit of Geriatrics, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128, Roma, Italy

    Alice Laudisio

  4. Fondazione Policlinico Universitario Campus Bio-Medico, Operative Research Unit of Geriatrics, Via Alvaro del Portillo, 200, 00128, Roma, Italy

    Alice Laudisio

  5. BIOMORF Department, Biomedical, Dental and Morphological and Functional Images, University of Messina. A.O.U. Policlinico “G.Martino”, Messina, Italy

    Biagio Zampogna

  6. Orthopaedic and Traumatology Department, Nuova Itor Clinic, Rome, Italy

    Matteo Papalia

  7. Department of Orthopaedics and Traumatology, ASL Roma 1, S. Filippo Neri Hospital, Rome, Italy

    Francesco Falez

Authors
  1. Biagio Zampogna
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  2. Francesco Rosario Parisi
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  3. Andrea Zampoli
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  4. Anna Prezioso
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  6. Alice Laudisio
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  7. Matteo Papalia
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  8. Nicola Papapietro
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  9. Francesco Falez
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  10. Rocco Papalia
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Contributions

All authors contributed to the study’s conception and design, and all authors read and approved the final manuscript.

Corresponding author

Correspondence to Alice Laudisio.

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Ethics approval

This study was performed following the principles of the Declaration of Helsinki. The Ethics Committee of Fondazione Policlinico Universitario Campus Bio-Medico approved.

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The authors grant permission for the publication of the study.

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The authors declare no competing interests.

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Level of evidence: Level III (retrospective comparative study with prospective cohort).

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Zampogna, B., Parisi, F.R., Zampoli, A. et al. Accuracy of two-dimensional digital planning in uncemented primary hip arthroplasty: monocentric analysis of eight hundred implants. International Orthopaedics (SICOT) (2024). https://doi.org/10.1007/s00264-024-06172-x

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