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Digital templating in total hip arthroplasty in the NHS: ‘computer says no…’

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Preoperative planning plays an important role in any surgical procedure and total hip replacement (THR) is no exception. Templating of radiographs allows preoperative assessment of the correct size of implant to be used, lowers the risk of periprosthetic fracture, helps restore femoral offset and leg length, facilitates the optimisation of alignment and ensures the correct implants sizes are available. All of these reduce the intraoperative pressures leading to the selection of incorrectly sized implants. This study assessed whether there is adequate provision of the current NHS Picture Archiving and Communication Systems (PACS) to allow optimal digital templating for THRs. Data were collected using a telephone questionnaire requesting information from the on-call orthopaedic SpR in 28 Greater London and surrounding area NHS Hospitals. PACS were used in all 28 (100%) hospitals that were contacted. Digital templating software was available in 14 (50%) hospitals. Despite this, none of them performed digital templating regularly. In the 50% that did have digital templating, this was not routinely done for the following reasons; only 3 (10.7%) allowed easy access to the software to the SpRs; only one SpR received formal training on how to use the system; only one hospital regularly used methods to accurately allow the software to assess magnification for accurate sizing (e.g. sizing balls). Digital PACS systems have made great improvements in the access of radiographs in the NHS. In orthopaedic practice, however, we have shown that the benefit of digital templating is being overlooked within the NHS.

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References

  1. Davila JA, Kransdorf MJ, Duffy GP (2006) Surgical planning of total hip arthroplasty: accuracy of computer assisted EndoMap software in predicting component size. Skeletal Radiol 35:390–393

    Article  PubMed  Google Scholar 

  2. Eggli S, Pisan M, Muller ME (1998) The value of preoperative planning for total hip arthroplasty. J Bone Joint Surg Br 80(3):382–90

    Google Scholar 

  3. Haddad FS et al (1999) The prevention of periprosthetic fractures in total hip and knee arthroplasty. Orthop Clin North Am 30(2):191–207

    Google Scholar 

  4. Bourne RB, Rorabeck CH (2002) Soft tissue balancing: the hip. J Arthroplasty 17(4 Suppl 1):17–22

    Google Scholar 

  5. Goodman SB, Huene DS, Imrie S (1992) Preoperative templating for the equalization of leg lengths in total hip arthroplasty. Contemp Orthop 24(6):703–710

    Google Scholar 

  6. Jasty M, Webster W, Harris W (1996) Management of limb length inequality during total hip replacement. Clin Orthop Relat Res (333):165–171

  7. Kosashvili Y et al (2009) Digital versus conventional templating techniques in preoperative planning for total hip arthroplasty. Can J Surg 52(1):6–11

    Google Scholar 

  8. White SP, Shardlow DL (2005) Effect of introduction of digital radiographic techniques on pre-operative templating in orthopaedic practice. Ann R Coll Surg Engl 87(1):53–54

    Google Scholar 

  9. The B et al (2007) Digital versus analogue preoperative planning of total hip arthroplasties: a randomized clinical trial of 210 total hip arthroplasties. J Arthroplasty 22(6):866–870

    Google Scholar 

  10. The B, Verdonschot N, van Horn JR, van Ooijen PM, Diercks RL (2007) Digital versus analogue preoperative planning of total hip arthroplasties: a randomized clinical trial of 210 total hip arthroplasties. J Arthroplasty 22(6):866–870

    Google Scholar 

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Conflict of interest

No funds were received in support of this study.

Author information

Authors and Affiliations

  1. University College London Hospitals, London, UK

    Luckshmana Jeyaseelan

  2. Northwick Park Hospital, London, UK

    Jonathan Ward & Kyriacos Eleftheriou

  3. Charing Cross Hospital, London, UK

    J. Cobb

Authors
  1. Luckshmana Jeyaseelan
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  2. Jonathan Ward
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  3. Kyriacos Eleftheriou
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  4. J. Cobb
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Corresponding author

Correspondence to Luckshmana Jeyaseelan.

Appendix: Study questionnaire

Appendix: Study questionnaire

Use of radiological templating in total hip arthroplasty within the NHS

Hospital:

Date of telephone survey:

Grade of surgeon spoken to:

  1. (1)

    Does the unit perform elective total hip arthroplasty on a regular basis?

  2. (2)

    Does the unit have a Picture Archiving and Communication Systems (PACS) system?

  3. (3)

    What PACS software is available?

  4. (4)

    Is digital templating software available?

  5. (5)

    If yes to the above question, what software is used?

  6. (6)

    Is there an option to obtain hard copies of X-rays?

  7. (7)

    Acetate templating available?

  8. (8)

    Is conventional hard-copy templating performed regularly (>80%)?

  9. (9)

    Is conventional hard-copy templating performed occasionally?

  10. (10)

    Is any training offered/available to surgeons on digital templating?

  11. (11)

    Is the digital software easily available, e.g. password locked?

  12. (12)

    Is digital templating performed regularly (>80%)?

  13. (13)

    Is digital templating performed occasionally?

  14. (14)

    Are all the required templates available on the software for all available prostheses?

  15. (15)

    Is magnification assessment performed and if so how frequently?

  16. (16)

    Overall comments on templating and potential reasons for lack of use?

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Jeyaseelan, L., Ward, J., Eleftheriou, K. et al. Digital templating in total hip arthroplasty in the NHS: ‘computer says no…’. Eur J Orthop Surg Traumatol 21, 397–399 (2011). https://doi.org/10.1007/s00590-010-0735-0

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  • DOI: https://doi.org/10.1007/s00590-010-0735-0

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