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KMID : 0386720030150030238
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Journal of the Korean Hip Society
2003 Volume.15 No. 3 p.238 ~ p.244
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Preoperative Planning of Total Hip Arthroplasty using Software Program for Templating
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Won Choong-Hee
Kim Yong-Min
Choi Eui-Sung
Shon Hyun-Chul
Park Kyoung-Jin
Nam Ki-Se
Jeong Jae-Jung
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Abstract
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Purpose: To develop a more accurate method for total hip arthroplasty by analyzing and comparing a new software templating method with that of conventional manual templating.
Materials & Methods: Between Oct. 1993 and Jun. 1995, fifty consecutive cases of primary total hip arthroplasty (THA) were chosen for this study. The inclusion criteria for the study hips were: the CLS$´ stem for the femur, and the Harris-Galante 0 cup for the acetabulum. A preoperative templating procedure was manually performed using the conventional templating method, and digitally using our own software program. For use of the software program, conventional radiographic images of the anteroposterior and lateral hips were retrieved into the program, and. the appropriate stem and cup sizes, and their location, were determined. The center of the hip, the offset and the amount of changes in the leg length were also calculated. The accuracy of both the manual and digital preoperative templating methods were compared using the postoperative x-ray images, with the actual surgical implants used as references.
Results: With the manual templating, there was correspondence in 21 cases (42%) with a real femoral stem, and in 17 (34%) with a real acetabular cup; in 27 cases (54%) with an ideal femoral stem, and in 21 (42%) with an ideal acetabular cup; and the leg length discrepancy was -3.9mm. With the digital templating, there was correspondence in 20 cases (40%) with a real femoral stem, and in 18 (36%) with a real acetabular cup; in 21 cases (42%) with an ideal femoral stem, and in 22 (44%) with an ideal acetabular cup; and the leg length discrepancies were -5.5 and 1.3mm pre- and postoperatively, respectively.
Conclusion: The digital templating method showed no advantages, over the conventional manual templating method, in selecting the implant size or in measuring the leg length discrepancy. However, it does allow for convenient fine adjustment of the template and fast measurement of the leg length discrepancy. Because both the conventional and digital methods cannot give exact results when hip X-rays are not taken in the correct position, great effort will be required for reducing these errors.
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KEYWORD
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Total hip arthroplasty, Software program, Digital templating
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