Conventional versus digital preoperative templating in primary total hip arthroplasty at Hospital Sultanah Bahiyah
Introduction and objectives: Templating is part of preoperative planning for total hip arthroplasty surgery. Conventionally this was done using on acetate transparent films overlaid on hard copy radiographs. With the emergence and implementation of digital radiograph, digital templating software...
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| Format: | Thesis |
| Language: | English |
| Published: |
2016
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| Subjects: | |
| Online Access: | http://eprints.usm.my/41990/1/Dr._Khoh_Phaik_Shan-24_pages.pdf |
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| Summary: | Introduction and objectives:
Templating is part of preoperative planning for total hip arthroplasty surgery.
Conventionally this was done using on acetate transparent films overlaid on hard copy
radiographs. With the emergence and implementation of digital radiograph, digital
templating software was introduced in total hip arthroplasty.
We conducted the study to compare the accuracy of conventional templating techniques
and digital templating techniques in primary total hip arthroplasty.
Methodology:
This was a retrospective study done on 73 cases where primary total hip arthroplasty was
performed for osteoarthritis, avascular necrosis of femoral head and femoral neck fracture
in Hospital Sultanah Bahiyah Alor Setar, Kedah, Malaysia from June 2011- June 2014. In
a separate sitting, conventional templating was performed using hard copy radiographic
films with implant specific templates whereas digital templating was performed using a
magnification- calibrated digital radiographic images and TraumaCadTM templating
software on a computer workstation. Paired t tests were used to determine the accuracy of
conventional templating versus digital templating. We also used Bland-Altman Method
and to determine the agreement between conventional method and actual implant as well
as digital method and actual implant.
Results:
Both the conventional and digital template had quite a good agreement with the actual
implant in predicting the acetabular cup and femoral stem size. However, digital
templating had higher agreement to the actual implant size as compared to conventional
templating in predicting the acetabular cup and femoral stem size.
Conventional templating significantly under predicted cup size (P-value = 0.003) and the
digital templating slightly over predicted the cup size but was not statistically significant
(P-value =0.501). Conventional templating significantly over predicted femoral stem size
( P-value = 0.004) while digital templating slightly over predicted the femoral stem size
but was not statistically significant (P-value =0.103). Therefore digital templating is more
accurate than conventional templating in the preoperative assessment.
Conclusion:
Digital templating is more accurate in predicting the acetabular cup and femoral stem size
than conventional templating using the available software.
Key words: Templating , conventional, digital, total hip arthroplasty |
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