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Dual-position calibration markers for total hip arthroplasty: theoretical comparison to fixed calibration and single marker method

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Abstract

Purpose

Digital templating is considered a standard for total hip arthroplasty. Different means for the necessary calibration of radiographs are known. While single marker calibration with radiopaque spheres is the most common, it is associated with possible significant deviations from the true magnification of the hip. Notably, fixed magnification factors showed better results. Therefore, a dual-position calibration marker method was simulated and compared to the established methods.

Methods

First, an empirical fixed magnification factor was identified and applied to a series of radiographs. Second, three magnification factors were generated based on sagittal patient data of 398 CT scans. These methods were compared to the fixed factor.

Results

The fixed factor was 122.6%. In the clinical application, the error of the fixed factor was 2.5% while the error of the single marker was 5.2%. In the CT cohort, the mean reference factor was 120.5% in females and 120.3% in males. The reference factor was compared to sex-specific means, sex-specific linear functions, and sex-specific cubic functions. The best results were found for the linear regression model with a mean difference of 0.8% from the reference value. No proportional bias was found (p = 0.623).

Conclusion

The simulation of the dual-position marker method using the linear regression model showed promising results, superior to all other methods. In future studies, its clinical application should be tested.

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Abbreviations

Abs:

Absolute

APP:

Anterior pelvic plane

CT:

Computed tomography

ECM:

External calibration marker

MF:

Magnification factor

Min:

Minimum

Max:

Maximum

THA:

Total hip arthroplasty

SD:

Standard deviation

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Author information

Authors and Affiliations

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

    Christoph Kolja Boese, Sebastian Wilhelm & Peer Eysel

  2. Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Cologne, Germany

    Stefan Haneder

  3. Center of Orthopedic and Trauma Surgery, University of Giessen and Marburg, Marburg, Germany

    Philipp Lechler

  4. Department of Spine Surgery, Schön Klinik Düsseldorf, Düsseldorf, Germany

    Jan Bredow

  5. Center for Orthopedics, Schön Klinik Düsseldorf SE & Co. KG, Am Heerdter Krankenhaus 2, 40549, Düsseldorf, Germany

    Jan Bredow

Authors
  1. Christoph Kolja Boese
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  2. Sebastian Wilhelm
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  3. Stefan Haneder
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  4. Philipp Lechler
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  5. Peer Eysel
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  6. Jan Bredow
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Corresponding author

Correspondence to Christoph Kolja Boese.

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Conflict of interest

CKB is an employee of Smith & Nephew GmbH, Germany. CKB may receive royalties from Medicad Hectec GmbH, Germany.

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Boese, C.K., Wilhelm, S., Haneder, S. et al. Dual-position calibration markers for total hip arthroplasty: theoretical comparison to fixed calibration and single marker method. International Orthopaedics (SICOT) 43, 589–595 (2019). https://doi.org/10.1007/s00264-018-4034-4

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  • DOI: https://doi.org/10.1007/s00264-018-4034-4

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