Three-dimensional pre-operative planning of primary hip arthroplasty: a systematic literature review

Abstract

Three-dimensional (3D) pre-operative planning in total hip arthroplasty (THA) is being recognized as a useful tool in planning elective surgery, and as crucial to define the optimal component size, position and orientation. The aim of this study was to systematically review the existing literature for the use of 3D pre-operative planning in primary THA. A systematic literature search was performed using keywords, through PubMed, Scopus and Google Scholar, to retrieve all publications documenting the use of 3D planning in primary THA. We focussed on (1) the accuracy of implant sizing, restoration of hip biomechanics and component orientation; (2) the benefits and barriers of this tool; and (3) current gaps in literature and clinical practice. Clinical studies have highlighted the accuracy of 3D pre-operative planning in predicting the optimal component size and orientation in primary THAs. Component size planning accuracy ranged between 34–100% and 41–100% for the stem and cup respectively. The absolute, average difference between planned and achieved values of leg length, offset, centre of rotation, stem version, cup version, inclination and abduction were 1 mm, 1 mm, 2 mm, 4°, 7°, 0.5° and 4° respectively. Benefits include 3D representation of the human anatomy for precise sizing and surgical execution. Barriers include increased radiation dose, learning curve and cost. Long-term evidence investigating this technology is limited. Emphasis should be placed on understanding the health economics of an optimized implant inventory as well as long-term clinical outcomes. Cite this article: EFORT Open Rev 2020;5:845-855. DOI: 10.1302/2058-5241.5.200046

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A laser guide technique: a novel method for accurate acetabular cup alignment in total hip arthroplasty

“…In modern THA, three-dimensional preoperative planning is being common because it is helpful to define the optimal component size, position, and orientation 28 . Accurate implant alignment accordingly leads to reduced intra- and postoperative complications and may lead to better implant longevity.…”

Deep Learning and Computer Vision Techniques for Automated Total Hip Arthroplasty Planning on 2-D Radiographs

“…Most published studies directly related to preoperative templating of THA have evaluated the accuracy and reliability of 2-D acetate and 2-D/3-D digital templating by comparing preoperative templating results with actual surgical results, prospectively [49]- [51] and retrospectively [52]- [57]. Systematic reviews and meta-analyses of these studies have also been published [4], [58], [59]. In summary, 1) 2-D and 3-D digital templating are reliable techniques for preoperative THA planning; 2) templating results are accurate in order of 3-D digital, 2-D digital, and 2-D acetate; and 3) templating is less accurate with uncemented prostheses than with cemented prostheses.…”