The reliability and accuracy of digital templating in total knee replacement

Trickett, Ryan W; Hodgson, P.; Forster, M.C.; Robertson, Angus

doi:10.1302/0301-620x.91b7.21476

Cited by 60 publications

(51 citation statements)

References 11 publications

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“…Directly compared to planning of the femoral component, templating of the tibial component was more accurate. Trickett et al reported similar results [24] whereas Miller et al reported a more accurate size planning for the femoral component [25].…”

Section: Discussionmentioning

confidence: 94%

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: 94%

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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“…In their study, they found the template of the femoral component was accurate 48% of the time and within 1 size 98% of the time. When they evaluated the tibia component, the template was accurate 55% of the time and within 1 size in 100% of their patients 6 . Specht et al evaluated accuracy of templating when comparing digital to acetate templating in TKA.…”

Section: Discussionmentioning

confidence: 99%

Algorithm based automatic templating is less accurate than manual digital templating in total knee arthroplasty

Seaver

McAlpine

García

et al. 2020

Journal Orthopaedic Research

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The purpose of the study was to evaluate the accuracy of a commercial automatic digital templating algorithm compared to manual digital templating in total knee arthroplasty (TKA). The study also evaluated if race and the presence of a standardized calibration marker on preoperative radiographs effect the accuracy of digital templating. One hundred twenty‐five consecutive patients undergoing primary TKA were included in the study. Patient demographics, etiology of arthritis, and the presence of a standardized calibration marker on preoperative anteroposterior (AP) and lateral radiographs was recorded. Manual digital templating and the use of the “auto‐knee” templating algorithm with “Traumacad” software was performed and recorded. Intraoperative sizes of the actual implants used were recorded. Pearson χ2 test was used to evaluate the accuracy of auto versus manual templating. Manual templating was within 1 size of the implant used intraoperatively for femoral and tibial implants 97.6% and 94.2% of the time, respectively. The “auto‐knee” algorithm was within one size of the implant used for femoral and tibial implants 51.2% and 71.2% of the time, respectively. The presence of a standardized calibration marker on the AP view did not change accuracy of templating for both components. There was no difference in accuracy of templating between races. We caution surgeons from exclusively using an automatic algorithm as it is less accurate than manual templating for TKA.

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“…Studies have shown mixed results for templating in knee and hip arthroplasty, although little information is known about its use for the shoulder. [26][27][28][29] There has been one study regarding the reliability and accuracy of pre-operative analogue templates in shoulder arthroplasty; however, no studies have been published using digital templating or evaluating the use of templating for humeral neck angle. 11 The present study measured the reliability and accuracy of pre-operative digital templating for predicting head size, stem size and neck angle in shoulder arthroplasty.…”

Section: Discussionmentioning

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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The reliability and accuracy of digital templating in total knee replacement

Cited by 60 publications

References 11 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

Algorithm based automatic templating is less accurate than manual digital templating in total knee arthroplasty

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

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