Effect of introduction of digital radiographic techniques on pre-operative templating in orthopaedic practice

White, Simon; Shardlow, D. L.

doi:10.1308/1478708051540

Cited by 41 publications

(24 citation statements)

References 3 publications

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“…Bayne et al report a magnification factor of 120 ±5%; in contrast, White and Shardlow found a factor of 97 % for digital templating compared with 115-120 % for analogue templating [9,17].…”

Section: Discussionmentioning

confidence: 93%

“…Prior to the introduction of digital radiography, planning was performed using hard-copy radiographic films and traditional prosthetic overlays with fixed magnification factors of 115 % or 120 % [4,9,10]. The introduction of digital radiography included the development of software programs to enable direct size selection planning on the digital image [11].…”

Section: Introductionmentioning

confidence: 99%

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Digital templating in total knee and hip replacement: an analysis of planning accuracy

Kniesel

Konstantinidis

Hirschmüller

et al. 2013

International Orthopaedics (SICOT)

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Purpose The aim of this study was to determine how well preoperative size selection for total knee and hip arthroplasties based on the digital imaging with and without additional referencing correlated with the size actually implanted. Methods Size selection planning of total knee arthroplasty by digital templating was documented in 46 cases with reference ball (group A) and in 48 cases without ball (group B). In addition, prospective analysis of pre-operative planning was conducted for 52 acetabular components with reference ball (group C) and 69 without ball (group D) as well as stem planning in 38 cases with ball (group E) and 54 cases without ball (group F). The data were analysed and compared with the size of the final component selected during surgery. Results The correlation between planned and implanted size for total knee arthroplasty in group A resulted in femoral anteroposterior (AP) r =0.8622 and lateral r =0.8333 and in group B AP r =0.4552 and lateral r =0.6950. Tibial in group A was AP r =0.9030 and lateral r =0.9074 and in group B AP r = 0.7000 and lateral r =0.6376. For the acetabular components, the results in group C were r =0.5998 and group D r =0.6923. For stems, group E was r =0.5306 and group F r =0.5786. No correlation between BMI and the difference between planned and implanted size was found in any of the groups. Conclusion In the case of total hip arthroplasty there was a relatively low correlation between planned and implanted sizes with or without reference ball. For total knee arthroplasties the already high precision of size planning was further improved by the additional referencing with a reference ball.

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Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Digital templating in total knee and hip replacement: an analysis of planning accuracy

Kniesel

Konstantinidis

Hirschmüller

et al. 2013

International Orthopaedics (SICOT)

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“…Most publications in leading orthopaedic journals have focused on the description and methodology involved in using the software [1] and, to the best of our knowledge, only one report on an analysis of its accuracy and friendliness has been published in the English literature [19,20]. This study was conducted to evaluate the utility and precision of digital preoperative templating for primary, conventional total hip arthroplasty for osteoarthritis.…”

Section: Discussionmentioning

confidence: 99%

“…Several software packages for preoperative templating on digital images have been developed [1,19,20]. Consequently, digital preoperative planning should be as useful and precise as the traditional method of acetate templates superimposed on standardised radiographs [8].…”

mentioning

confidence: 99%

The utility and precision of analogue and digital preoperative planning for total hip arthroplasty

Valle

Comba

Taveras

et al. 2007

International Orthopaedics (SICO

100

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We prospectively compared the utility and precision of preoperative templating performed in printed films (analogue) with that performed on digital radiographs (digital) in 69 patients undergoing primary total hip replacement. Five patients were excluded when misplacement of the marker resulted in a magnification error greater that 10%; in the remaining patients (64 hips), the cup size was within ± one size in 62 (97%) of the analogue and 52 (81%) of the digital (p=0.01) plans. The stem size was within ± one size in 63 (98%) of the analogue and 60 (94%) of the digital (p=0.39) plans. The distance from the proximal corner of the lesser trochanter to the center of the prosthetic head (LTCD) in the analogue differed by 5 mm or more from the digital plan in nine cases (14%). Analogue preoperative planning yielded more predictable results than digital planning, particularly in terms of acetabular component size and LTCD that dictates limb lengtheningshortening. The sources of error were not clearly explained by variations in magnification. Inconsistent positioning of the magnification marker may jeopardise the safe implementation of digital templating.Résumé Nous avons, de façon prospective, comparé l'utilité et la précision de la planification préopératoire réalisée sur des films radiologiques classiques ou sur des radiographies numérisées sur 69 patients devant bénéficier d'une prothèse totale de hanche. 5 patients ont été exclus car il existait une erreur de plus de 10% sur le coefficient d'agrandissement et sur les 64 hanches restantes, la taille prévue de la cupule correspondant dans 97% des cas (62 hanches) sur les films classiques et dans 81% des cas (52 hanches) sur les films numérisés. La taille de la pièce fémorale était celle prévue dans 98% des cas (63 hanches) sur les films classiques, dans 94% des cas (60 hanches) sur les films numérisés. La distance entre bord proximal du petit trochanter et la tête prothétique (LTCD) sur les films classiques, n'a pas montré de différence de plus de 5 millimètres. Cette distance était supérieure dans 9 cas (14%) sur les films numérisés. Une planification pré opératoire est beaucoup plus fiable sur les films classiques que sur les films numérisés, particulièrement en ce qui concerne la taille du composant acétabulaire et les problèmes d'inégalité de longueurs. Les sources d'erreur ne sont pas très clairement expliquées par les modifications du taux d'agrandissement, la planification sur des clichés numérisés peut être source d'erreur.

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“…14,15 Digital templating offers a way to avoid these errors with quicker, more cost-efficient templating that can be easily stored for future reference. 16 It has also been shown that the accuracy of pre-operative digital templating in knee and hip arthroplasty meets or exceeds that of analogue templating, thus giving more support for the use of entirely digital techniques.…”

Section: Introductionmentioning

confidence: 99%

Reliability and accuracy of digital templating for the humeral component of total shoulder arthroplasty

Lee

Davis

Lane³

et al. 2014

Shoulder & Elbow

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Background: This experimental study evaluated the interobserver reliability and accuracy of pre-operative digital templating for humeral head size, stem size and neck angle for total shoulder arthroplasty. Methods: Twenty-five patients underwent a total shoulder arthroplasty with a single prosthesis. Four independent, blinded surgeons (two experienced shoulder surgeons and two PGY-6 fellows) used pre-operative radiographs and templating software to generate templates of the humeral head, stem and neck for each patient. Interobserver reliability was calculated using weighted kappa (k) analysis. Accuracy was assessed by comparing templates to actual implant sizes. Results: Interobserver reliability was fair to substantial (k ¼ 0.26 to 0.71) for head size, fair to substantial (k ¼ 0.39 to 0.72) for stem size and slight to fair (k ¼ 0.16 to 0.34) for neck angle. Templated head size, stem size and neck angle had accuracies of 53%, 77% and 68% within one size variation, respectively. Experience did not affect accuracy (p ¼ 0.11 to 0.48). Conclusions: Digital templating is not a useful guide for pre-operative surgical planning and should not be used to select a prosthesis.

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Effect of introduction of digital radiographic techniques on pre-operative templating in orthopaedic practice

Abstract: Surgeons should be aware that introduction of digital techniques of radiograph acquisition may reduce the magnification of the film and, therefore, reduce the accuracy of pre-operative templates supplied by the manufacturers of implants, resulting in incorrect selection of implants.

Cited by 41 publications

References 3 publications

Digital templating in total knee and hip replacement: an analysis of planning accuracy

Digital templating in total knee and hip replacement: an analysis of planning accuracy

The utility and precision of analogue and digital preoperative planning for total hip arthroplasty

Reliability and accuracy of digital templating for the humeral component of total shoulder arthroplasty

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