Case Control Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Jan 18, 2017; 8(1): 30-35
Published online Jan 18, 2017. doi: 10.5312/wjo.v8.i1.30
Digital templating in total hip arthroplasty: Additional anteroposterior hip view increases the accuracy
Sophia K Stigler, Franz J Müller, Sebastian Pfaud, Michael Zellner, Bernd Füchtmeier
Sophia K Stigler, Franz J Müller, Sebastian Pfaud, Michael Zellner, Bernd Füchtmeier, Clinic for Trauma, Orthopaedic and Sports Medicine, Hospital Barmherzige Brüder, 93049 Regensburg, Germany
Author contributions: Stigler SK collected, analysed the data and wrote the manuscript; Müller FJ contributed in final editing of the manuscript; Stigler SK, Müller FJ, Pfaud S, Zellner M corrected the manuscript; Füchtmeier B designed and supervised the study, acquired the data; all authors approved the definite version of the manuscript.
Institutional review board statement: Institutional review board approval.
Informed consent statement: An informed consent statement was given.
Conflict-of-interest statement: All authors declare that there is no conflict of interest. For this work no benefits in any form were received.
Data sharing statement: No data sharing is required.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. med. Franz Müller, habil., Clinic for Trauma, Orthopaedic and Sports Medicine, Hospital Barmherzige Brüder, Prüfeninger Str. 86, 93049 Regensburg, Germany. franz.mueller@barmherzige-regensburg.de
Telephone: +49-941-3692251 Fax: +49-941-3692255
Received: July 17, 2016
Peer-review started: July 18, 2016
First decision: September 2, 2016
Revised: September 21, 2016
Accepted: December 1, 2016
Article in press: December 2, 2016
Published online: January 18, 2017
Abstract
AIM

To analyze planning total hip arthroplasty (THA) with an additional anteroposterior hip view may increases the accuracy of preoperative planning in THA.

METHODS

We conducted prospective digital planning in 100 consecutive patients: 50 of these procedures were planned using pelvic overview only (first group), and the other 50 procedures were planned using pelvic overview plus antero-posterior (a.p.) hip view (second group). The planning and the procedure of each patient were performed exclusively by the senior surgeon. Fifty procedures with retrospective analogues planning were used as the control group (group zero). After the procedure, the planning was compared with the eventually implanted components (cup and stem). For statistic analysis the χ2 test was used for nominal variables and the t test was used for a comparison of continuous variables.

RESULTS

Preoperative planning with an additional a.p. hip view (second group) significantly increased the exact component correlation when compared to pelvic overview only (first group) for both the acetabular cup and the femoral stem (76% cup and 66% stem vs 54% cup and 32% stem). When considering planning ± 1 size, the accuracy in the second group was 96% (48 of 50 patients) for the cup and 94% for the stem (47 of 50 patients). In the analogue control group (group zero), an exact correlation was observed in only 1/3 of the cases.

CONCLUSION

Digital THA planning performed by the operating surgeon and based on additional a.p. hip view significantly increases the correlation between preoperative planning and eventual implant sizes.

Keywords: Digital, Templating, Preoperative planning, Hip view, Total hip arthroplasty

Core tip: Preoperative planning is an essential practice carried out prior to total hip arthroplasty (THA). However, the accuracy of digital preoperative planning in THA is variable and often lacks sufficient precision. Our prospective study analysed that preoperative planning with an additional antero-posterior hip view significantly increased the exact component correlation when compared to pelvic overview only for both the acetabular cup and the femoral.