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Smith JBV, Bishi H, Wang C, Asopa V, Field RE, Sochart DH. The accuracy and reliability of preoperative digital 2D templating in prosthesis size prediction in uncemented versus cemented total hip arthroplasty: a systematic review and meta-analysis. EFORT Open Rev 2021; 6:1020-1039. [PMID: 34909222 PMCID: PMC8631246 DOI: 10.1302/2058-5241.6.210048] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The purpose of this study was to compare the accuracy and the inter- and intra-observer reliability of preoperative digital 2D templating in prosthesis size prediction for the planning of cemented or uncemented THA. This study was registered in the NIHR PROSPERO database (ID: CRD42020216649) and conducted according to the PRISMA guidelines. A search of electronic databases in March 2021 found 29 papers overall. The quality of evidence was assessed using the IHE Quality Appraisal of Case Series Studies Checklist and the CASP Randomised Controlled Trials Checklist. A meta-analysis was conducted, and the accuracy was presented as proportions and the inter- and intra-observer reliability were measured using intraclass correlation coefficients (ICC). Accuracy within one prosthesis size (±1) for cemented stems was 0.89 (95% confidence interval (CI) 0.83–0.95), cemented cups 0.78 (95% CI 0.67–0.89), uncemented stems 0.74 (95% CI 0.66–0.82) and uncemented cups 0.73 (95% CI 0.67–0.79) (test of group differences: p = 0.010). Inter-observer reliability (ICC) for uncemented cups was 0.88 (95% CI 0.85–0.91), uncemented stems 0.86 (95% CI 0.81–0.91), cemented stems 0.69 (95% CI 0.54–0.84) and cemented cups 0.68 (95% CI 0.55–0.81) (test of group differences: p = 0.004). Due to lack of data, intra-observer reliability (ICC) could only be calculated for uncemented prostheses, which for the stems was 0.90 (95% CI 0.88–0.92) and for the cups was 0.87 (95% CI 0.83–0.90) (test of group differences: p = 0.124). The accuracy of preoperative digital templating is greater for cemented prostheses, but the inter-observer reliability is greater for uncemented prostheses. The intra-observer reliability showed a high level of agreement for uncemented prostheses.
Cite this article: EFORT Open Rev 2021;6:1020-1039. DOI: 10.1302/2058-5241.6.210048
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Affiliation(s)
- Joshua B V Smith
- Academic Surgical Unit, South West London Elective Orthopaedic Unit, Epsom, Surrey, UK
| | - Habeeb Bishi
- Academic Surgical Unit, South West London Elective Orthopaedic Unit, Epsom, Surrey, UK
| | - Chao Wang
- Kingston University and St George's University of London, Tooting, London, UK
| | - Vipin Asopa
- Academic Surgical Unit, South West London Elective Orthopaedic Unit, Epsom, Surrey, UK
| | - Richard E Field
- Academic Surgical Unit, South West London Elective Orthopaedic Unit, Epsom, Surrey, UK
| | - David H Sochart
- Academic Surgical Unit, South West London Elective Orthopaedic Unit, Epsom, Surrey, UK
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Montiel V, Troncoso S, Valentí-Azcárate A, Valentí-Nin JR, Lamo-Espinosa JM. Total Hip Arthroplasty Digital Templating: Size Predicting Ability and Interobserver Variability. Indian J Orthop 2020; 54:840-847. [PMID: 33133407 PMCID: PMC7572938 DOI: 10.1007/s43465-020-00217-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 07/23/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND During the last century, total hip arthroplasties have become more popular. They have had a huge impact on the quality of life, pain, range of motion, social interaction, and psychological well-being. A number of studies have emphasized the importance of using templates to choose the appropriate implant size when planning the surgery. Our aim is to use MediCad® software to analyze the ability of the digital template system MediCad® to predict the size of the implant needed in total hip arthroplasties. MATERIALS AND METHODS An arthroplasty preoperative plan was created according to the MediCad® software guidelines, on anteroposterior hip X-ray by one junior resident, one senior resident, and three experienced hip surgeons. RESULTS The median size accuracy was 0.7 (range: 0.27-0.87) for the cup, 0.73 (range: 0.36-0.83) for the stem, and 0.28 (range: -0.14-0.69) for the neck. Interobserver reliability was good (kappa > 0.4) and stronger when measuring the stem than when doing so with the cup. Conclusion: Digital preoperative total hip arthroplasty planning is a good method for predicting component size, restoring hip anatomy (vertical offset and horizontal offset), with good interobserver reliability.
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Affiliation(s)
- Veronica Montiel
- grid.411730.00000 0001 2191 685XDepartment of Orthopedic Surgery and Traumatology, Clínica Universidad de Navarra, Av. Pio XII, 36, 31008 Pamplona, Navarra Spain
| | - Santiago Troncoso
- grid.411730.00000 0001 2191 685XDepartment of Orthopedic Surgery and Traumatology, Clínica Universidad de Navarra, Av. Pio XII, 36, 31008 Pamplona, Navarra Spain
| | - Andrés Valentí-Azcárate
- grid.411730.00000 0001 2191 685XDepartment of Orthopedic Surgery and Traumatology, Clínica Universidad de Navarra, Av. Pio XII, 36, 31008 Pamplona, Navarra Spain
| | - Juan Ramón Valentí-Nin
- grid.411730.00000 0001 2191 685XDepartment of Orthopedic Surgery and Traumatology, Clínica Universidad de Navarra, Av. Pio XII, 36, 31008 Pamplona, Navarra Spain
| | - Jose María Lamo-Espinosa
- grid.411730.00000 0001 2191 685XDepartment of Orthopedic Surgery and Traumatology, Clínica Universidad de Navarra, Av. Pio XII, 36, 31008 Pamplona, Navarra Spain
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Gallart X, Fernández-Valencia JA, Ríos G, Bori G, Riba J, Muñoz-Mahamud E, Combalía A. Early clinical and radiological outcomes for the Taperloc Complete Microplasty stem. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2018; 29:619-624. [PMID: 30411245 DOI: 10.1007/s00590-018-2341-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 11/03/2018] [Indexed: 12/14/2022]
Abstract
The use of short stem designs in total hip arthroplasty is not a new concept, but its popularity has increased as a bone-sparing alternative to traditional stems. This study analyzed the midterm clinical and radiological results of the Taperloc Complete Microplasty stem (Zimmer Biomet® Warsaw, IN, USA). A total of 32 patients (20 men and 12 women) were retrospectively documented and received 40 stems (eight bilateral). The median patient age was 50 years (interquartile range 43-58) at the time of surgery. The median follow-up was 36.5 months (interquartile range 26.75-50.25). Indication for total hip arthroplasty was osteoarthritis (62.5% of patients), avascular necrosis (25%), and developmental dysplasia of the hip (12.5%). The Merle d'Aubigné score improved from a mean 11.5 preoperatively to a mean 17.5 at the latest follow-up. During X-ray assessment, we observed one subsidence of the stem (3 mm) and four cases of varus malalignment without clinical consequences. No cases of osteolysis were reported, and no stems were revised. According to our results, this short tapered stem shows a good early-term outcome. Prospective results and a longer follow-up are needed to assess the long-term survival of this stem fully.
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Affiliation(s)
- Xavier Gallart
- Hip Unit, Department of Orthopaedic Surgery and Traumatology, Hospital Clínic, University of Barcelona, C/ Villarroel 170, 08036, Barcelona, Spain
| | - Jenaro A Fernández-Valencia
- Hip Unit, Department of Orthopaedic Surgery and Traumatology, Hospital Clínic, University of Barcelona, C/ Villarroel 170, 08036, Barcelona, Spain.
| | - Gina Ríos
- Hip Unit, Department of Orthopaedic Surgery and Traumatology, Hospital Clínic, University of Barcelona, C/ Villarroel 170, 08036, Barcelona, Spain
| | - Guillem Bori
- Hip Unit, Department of Orthopaedic Surgery and Traumatology, Hospital Clínic, University of Barcelona, C/ Villarroel 170, 08036, Barcelona, Spain
| | - Josep Riba
- Hip Unit, Department of Orthopaedic Surgery and Traumatology, Hospital Clínic, University of Barcelona, C/ Villarroel 170, 08036, Barcelona, Spain
| | - Ernesto Muñoz-Mahamud
- Hip Unit, Department of Orthopaedic Surgery and Traumatology, Hospital Clínic, University of Barcelona, C/ Villarroel 170, 08036, Barcelona, Spain
| | - Andres Combalía
- Hip Unit, Department of Orthopaedic Surgery and Traumatology, Hospital Clínic, University of Barcelona, C/ Villarroel 170, 08036, Barcelona, Spain
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