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The accuracy of digital templating: a comparison of short-stem total hip arthroplasty and conventional total hip arthroplasty

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Abstract

Purpose

Selection of the correct femoral stem size is crucial in total hip arthroplasty for an uncomplicated implantation and good initial stability. Pre-operative templating has been shown to be a valuable tool in predicting the correct implant size. For short-stem total hip arthroplasty (SHA), which recently is increasingly used, it is unknown if templating can be performed as reliable as conventional total hip arthroplasty (THA).

Methods

A total of 100 hip arthroplasties, 50 with SHA and 50 with THA, were templated by four orthopaedic surgeons each. The surgeons had different levels of professional experience and performed a digital template of the acetabular and femoral component on the pre-operative radiographs. The results were compared with the truly inserted implant size.

Results

For the femoral stems the average percentage of agreement (±1 size) was 89.0 % in SHA and 88.5 % in THA. There was no significant difference among surgeons in the accuracy of templating the correct stem size and no significant difference between templating SHA and THA. For the acetabular component the average percentage of agreement (±1 size) was 75.8 %. However, the more experienced surgeons showed a significant higher accuracy for templating the correct cup size than the less experienced surgeons.

Conclusion

Digital templating of SHA can predict the stem sizes as accurately as conventional THA. Therefore digital templating is also recommendable for SHA, as it helps to predict the implant size prior to surgery and thereby might help to avoid complications.

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References

  1. Eggli S, Pisan M, Muller ME (1998) The value of preoperative planning for total hip arthroplasty. J Bone Joint Surg Br 80(3):382–390

    Article  PubMed  CAS  Google Scholar 

  2. Haddad FS, Masri BA, Garbuz DS, Duncan CP (1999) The prevention of periprosthetic fractures in total hip and knee arthroplasty. Orthop Clin North Am 30(2):191–207

    Article  PubMed  CAS  Google Scholar 

  3. Suh KT, Cheon SJ, Kim DW (2004) Comparison of preoperative templating with postoperative assessment in cementless total hip arthroplasty. Acta Orthop Scand 75(1):40–44

    Article  PubMed  Google Scholar 

  4. Della Valle AG, Padgett DE, Salvati EA (2005) Preoperative planning for primary total hip arthroplasty. J Am Acad Orthop Surg 13(7):455–462

    PubMed  Google Scholar 

  5. Della Valle AG, Comba F, Taveras N, Salvati EA (2008) The utility and precision of analogue and digital preoperative planning for total hip arthroplasty. Int Orthop 32(3):289–294

    Article  Google Scholar 

  6. Fottner A, Steinbruck A, Sadoghi P, Mazoochian F, Jansson V (2011) Digital comparison of planned and implanted stem position in total hip replacement using a program form migration analysis. Arch Orthop Trauma Surg 131(7):1013–1019

    Article  PubMed  Google Scholar 

  7. 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

    Article  PubMed  Google Scholar 

  8. Zhao X, Zhu ZA, Zhao J, Li MQ, Wang G, Yu DG, Yu B (2011) The utility of digital templating in total hip arthroplasty with Crowe type II and III dysplastic hips. IntOrthop 35(5):631–638

    Google Scholar 

  9. Whiddon DR, Bono JV, Lang JE, Smith EL, Salyapongse AK (2011) Accuracy of digital templating in total hip arthroplasty. Am J Orthop (Belle Mead NJ) 40(8):395–398

    Google Scholar 

  10. Wedemeyer C, Quitmann H, Xu J, Heep H, von Knoch M, Saxler G (2008) Digital templating in total hip arthroplasty with the Mayo stem. Arch Orthop Trauma Surg 128(10):1023–1029

    Article  PubMed  Google Scholar 

  11. Iorio R, Siegel J, Specht LM, Tilzey JF, Hartman A, Healy WL (2009) A comparison of acetate vs digital templating for preoperative planning of total hip arthroplasty: is digital templating accurate and safe? J Arthroplasty 24(2):175–179

    Article  PubMed  Google Scholar 

  12. Gamble P, de Beer J, Petruccelli D, Winemaker M (2010) The accuracy of digital templating in uncemented total hip arthroplasty. J Arthroplasty 25(4):529–532

    Article  PubMed  Google Scholar 

  13. Morrey BF, Adams RA, Kessler M (2000) A conservative femoral replacement for total hip arthroplasty. A prospective study. J Bone Joint Surg Br 82(7):952–958

    Article  PubMed  CAS  Google Scholar 

  14. Kamada S, Naito M, Nakamura Y, Kiyama T (2011) Hip abductor muscle strength after total hip arthroplasty with short stems. Arch Orthop Trauma Surg 131(12):1723–1732

    Article  PubMed  Google Scholar 

  15. Bono JV (2004) Digital templating in total hip arthroplasty. J Bone Joint Surg Am 86-A(Suppl 2):118–122

    PubMed  Google Scholar 

  16. Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33(1):159–174

    Article  PubMed  CAS  Google Scholar 

  17. Briem D, Schneider M, Bogner N, Botha N, Gebauer M, Gehrke T, Schwantes B (2011) Mid-term results of 155 patients treated with a collum femoris preserving (CFP) short stem prosthesis. Int Orthop 35(5):655–660

    Article  PubMed  Google Scholar 

  18. Lerch M, von der Haar-Tran A, Windhagen H, Behrens BA, Wefstaedt P, Stukenborg-Colsman CM (2012) Bone remodelling around the Metha short stem in total hip arthroplasty: a prospective dual-energy X-ray absorptiometry study. Int Orthop 36(3):533–541

    Article  PubMed  Google Scholar 

  19. Hsu AR, Kim JD, Bhatia S, Levine BR (2012) Effect of training level on accuracy of digital templating in primary total hip and knee arthroplasty. Orthopedics 35(2):e179–e183

    PubMed  Google Scholar 

  20. Crooijmans HJ, Laumen AM, van Pul C, van Mourik JB (2009) A new digital preoperative planning method for total hip arthroplasties. Clin Orthop Relat Res 467(4):909–916

    Article  PubMed  Google Scholar 

  21. Zeh A, Radetzki F, Diers V, Bach D, Rollinghoff M, Delank KS (2011) Is there an increased stem migration or compromised osteointegration of the Mayo short-stemmed prosthesis following cerclage wiring of an intrasurgical periprosthetic fracture? Arch Orthop Trauma Surg 131(12):1717–1722

    Article  PubMed  Google Scholar 

  22. Jakubowitz E, Seeger JB, Lee C, Heisel C, Kretzer JP, Thomsen MN (2009) Do short-stemmed-prostheses induce periprosthetic fractures earlier than standard hip stems? A biomechanical ex-vivo study of two different stem designs. Arch Orthop Trauma Surg 129(6):849–855

    Article  PubMed  Google Scholar 

  23. Mittag F, Ipach I, Schaefer R, Meisner C, Leichtle U (2012) Predictive value of preoperative digital templating in THA depends on the surgical experience of the performing physician. Orthopedics 35(2):e144–e147

    PubMed  Google Scholar 

  24. Carter LW, Stovall DO, Young TR (1995) Determination of accuracy of preoperative templating of noncemented femoral prostheses. J Arthroplasty 10(4):507–513

    Article  PubMed  CAS  Google Scholar 

  25. Efe T, El Zayat BF, Heyse TJ, Timmesfeld N, Fuchs-Winkelmann S, Schmitt J (2011) Precision of preoperative digital templating in total hip arthroplasty. Acta Orthop Belg 77(5):616–621

    PubMed  Google Scholar 

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Acknowledgment

The authors thank Michael Lauseker from the Institute of Medical Informatics Biometry Epidemiology (IBE) for the expert advice in statistics.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Campus Grosshadern, University Hospital of Munich (LMU), Munich, Germany

    Florian Schmidutz, Arnd Steinbrück, Lorenz Wanke-Jellinek, Matthias Pietschmann, Volkmar Jansson & Andreas Fottner

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  1. Florian Schmidutz
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  2. Arnd Steinbrück
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  3. Lorenz Wanke-Jellinek
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  4. Matthias Pietschmann
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  5. Volkmar Jansson
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  6. Andreas Fottner
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Correspondence to Florian Schmidutz.

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Schmidutz, F., Steinbrück, A., Wanke-Jellinek, L. et al. The accuracy of digital templating: a comparison of short-stem total hip arthroplasty and conventional total hip arthroplasty. International Orthopaedics (SICOT) 36, 1767–1772 (2012). https://doi.org/10.1007/s00264-012-1532-7

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  • DOI: https://doi.org/10.1007/s00264-012-1532-7

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