Accuracy of digital templating in uncemented primary total hip arthroplasty: which factors are associated with accuracy of preoperative planning?,Hip International

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Accuracy of digital templating in uncemented primary total hip arthroplasty: which factors are associated with accuracy of preoperative planning?
Hip International ( IF 1.3 ) Pub Date : 2022-04-19 , DOI: 10.1177/11207000221082026
Andrew Adamczyk _{1,

2} , Pierre Laboudie _{1,

2} , Hamid Nessek ₂ , Paul R Kim _{1,

2} , Wade T Gofton _{1,

2} , Robert Feibel _{1,

2} , George Grammatopoulos _{1,

2}

Affiliation

Background:

Preoperative planning is a fundamental step for successful total hip arthroplasty (THA). Studies have highlighted the accuracy of preoperative digital templating for estimating acetabular cup and stem size. Stem design such as single-wedge metadiaphyseal (Type 1 stem) versus mid-short stem (microplasty) and surgical approach (anterior, direct lateral or posterior) have not been well investigated as predictors of THA templating accuracy.

Methods:

204 patients (220 hips) who had undergone elective THA between November 2016 and December 2019 and presented a saved preoperative template were retrospectively reviewed. Templates from 5 different surgeons were involved in the analysis. 3 different approaches were used: direct lateral (DL), posterior (PA), direct anterior (DAA). 2 different stem designs were used: single-wedge metadiaphyseal and single-wedge mid-short (Biomet Taperloc Microplasty), while the acetabular component remained the same. Bivariate and multivariate regression analyses were performed to determine predictors of accuracy.

Results:

Femoral component size templating accuracy was significantly improved when using the single-wedge mid-short stem (Taperloc Microplasty) design when performing bivariate analysis. Although accuracy of cup sizing was not affected by approach, precision was significantly better in the PA group (p < 0.05). Accuracy of templating was found to be independent of BMI and gender but dependent on presence of calibration marker and stem design (p < 0.05).

Conclusions:

When striving for improved templating accuracy, acetabular and femoral component accuracy were best achieved using a calibration marker and a metaphyseal short femoral stem design.

中文翻译：

非骨水泥初次全髋关节置换术中数字模板的准确性：哪些因素与术前计划的准确性相关？

背景：

术前计划是成功进行全髋关节置换术 (THA) 的基本步骤。研究强调了术前数字模板在估计髋臼杯和柄尺寸方面的准确性。茎杆设计，例如单楔形干骺端（1 型茎杆）与中短茎杆（显微成形术）和手术入路（前路、直接侧路或后路）作为 THA 模板准确性的预测因素尚未得到很好的研究。

方法：

回顾性分析了 2016 年 11 月至 2019 年 12 月期间接受择期 THA 并提供保存的术前模板的 204 例患者（220 髋）。来自 5 位不同外科医生的模板参与了分析。使用了 3 种不同的方法：直接侧向 (DL)、后向 (PA)、直接前向 (DAA)。使用了 2 种不同的假体设计：单楔形干骺端和单楔形中短（Biomet Taperloc Microplasty），而髋臼组件保持不变。进行双变量和多变量回归分析以确定准确性的预测因子。

结果：

在执行双变量分析时，当使用单楔形中短柄（Taperloc Microplasty）设计时，股骨部件尺寸模板的准确性显着提高。虽然罩杯尺寸的准确性不受方法的影响，但 PA 组的精度明显更好（p < 0.05）。发现模板的准确性与 BMI 和性别无关，但取决于校准标记和茎设计的存在 ( p < 0.05)。