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Influence of calibration on digital templating of hip arthroplasty

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Abstract

Introduction

Digital templating for total joint replacement is the current standard. For image calibration, external calibration markers (ECM) are used. However, there are concerns regarding the precision of the method. This study aimed to identify the direct influence of calibration errors on digital templating.

Patients and methods

A retrospective analysis of 100 post-operative radiographs with unilateral total hip arthroplasty was performed. The magnification factor of the ECM and of the internal prosthetic femoral head (ICM) as a reference value was calculated for each radiograph. Two blinded observers performed templating of the contralateral hip using a randomized list for all radiographs and both markers. The component size templated by the ECM magnification was compared to the reference by the ICM magnification.

Results

Mean magnification factors of ICM and ECM differed significantly (p = 0.006). The absolute difference was 5.2% (range 0.0–23.3%, SD 4.8%). Templating of the acetabular or the femoral component showed no significant differences (p = 0.120, p = 0.599). Differences of more than one size were found in 26% of the acetabular components and 14% of the femoral components and differences over two sizes in 10% respectively 3%. Correlation coefficients for magnification error and size differences of acetabular components were − 0.645 (p < 0.001) and for the femoral component − 0.607 (p < 0.001).

Interpretation

The calibration error of external calibration markers in digital templating for hip replacement influences component sizes significantly. Thus, correct positioning of ECM is of utmost importance.

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Abbreviations

a.p.:

Anteroposterior

ECM:

External calibration marker

ICM:

Internal calibration marker (i.e., THA head)

THA:

Total hip arthroplasty

References

  1. Shaarani SR, McHugh G, Collins DA (2013) Accuracy of digital preoperative templating in 100 consecutive uncemented total hip arthroplasties: a single surgeon series. J Arthroplasty 28(2):331–337

    Article  PubMed  Google Scholar 

  2. Boese CK, Lechler P, Rose L, Dargel J, Oppermann J, Eysel P et al (2015) Calibration markers for digital templating in total hip arthroplasty. PLoS One 10(7):e0128529

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Boese CK, Bredow J, Dargel J, Eysel P, Geiges H, Lechler P (2016) Calibration marker position in digital templating of total hip arthroplasty. J Arthroplast 31(4):883–887

    Article  Google Scholar 

  4. Franken M, Grimm B, Heyligers I (2010) A comparison of four systems for calibration when templating for total hip replacement with digital radiography. J Bone Joint Surg Br 92(1):136–141

    Article  CAS  PubMed  Google Scholar 

  5. Sinclair VF, Wilson J, Jain NP, Knowles D (2014) Assessment of accuracy of marker ball placement in pre-operative templating for total hip arthroplasty. J Arthroplast 29(8):1658–1660

    Article  Google Scholar 

  6. Archibeck MJ, Tripuraneni KR, Carothers JT, Junick DW, Munson NR, Murray-Krezan CM (2017) Prospective, randomized, surgeon-blinded comparison of standard magnification assumption vs magnification marker usage for preoperative templating in total hip arthroplasty. J Arthroplast 32(10):3061–3064

    Article  Google Scholar 

  7. Efe T, El Zayat BF, Heyse TJ, Timmesfeld N, Fuchs-Winkelmann S, Schmitt J (2011) Precision of preoperative digital templating in total hip arthroplasty. Acta Orthop Belg 77(5):616–621

    PubMed  Google Scholar 

  8. Iorio R, Siegel J, Specht LM, Tilzey JF, Hartman A, Healy WL (2009) A comparison of acetate vs digital templating for preoperative planning of total hip arthroplasty: is digital templating accurate and safe? J Arthroplasty 24(2):175–179

    Article  PubMed  Google Scholar 

  9. Whitley E, Ball J (2002) Statistics review 4: sample size calculations. Crit Care 6(4):335–341

    Article  PubMed  PubMed Central  Google Scholar 

  10. Baxter JA, Barlow T, Karthikeyan S, Mayo DJ, King RJ (2012) The accuracy of automatic calibration of digital pelvic radiographs using two different scale markers: a comparative study. Hip Int 22(1):82–89

    Article  PubMed  Google Scholar 

  11. Bayne CO, Krosin M, Barber TC (2009) Evaluation of the accuracy and use of x-ray markers in digital templating for total hip arthroplasty. J Arthroplast 24(3):407–413

    Article  Google Scholar 

  12. Kniesel B, Konstantinidis L, Hirschmuller A, Sudkamp N, Helwig P (2014) Digital templating in total knee and hip replacement: an analysis of planning accuracy. Int Orthop 38(4):733–739

    Article  PubMed  Google Scholar 

  13. Lakstein D, Bachar I, Debi R, Lubovsky O, Cohen O, Tan Z et al (2017) Radiographic templating of total hip arthroplasty for femoral neck fractures. Int Orthop 41(4):831–836

    Article  PubMed  Google Scholar 

  14. The B, Diercks RL, van Ooijen PM, van Horn JR (2005) Comparison of analog and digital preoperative planning in total hip and knee arthroplasties. A prospective study of 173 hips and 65 total knees. Acta Orthop 76(1):78–84

    Article  PubMed  Google Scholar 

  15. Gamble P, de Beer J, Petruccelli D, Winemaker M (2010) The accuracy of digital templating in uncemented total hip arthroplasty. J Arthroplast 25(4):529–532

    Article  Google Scholar 

  16. Boese CK, Wilhelm S, Haneder S, Lechler P, Eysel P, Bredow J (2018) Dual-position calibration markers for total hip arthroplasty: theoretical comparison to fixed calibration and single marker method. Int Orthop. https://doi.org/10.1007/s00264-018-4034-4

  17. Ohmori T, Kabata T, Kajino Y, Taga T, Hasegawa K, Inoue D et al (2018) Differences in range of motion with the same combined anteversion after total hip arthroplasty. Int Orthop 42(5):1021–1028

    Article  PubMed  Google Scholar 

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Acknowledgements

Parts of the study were presented at the annual meeting of German orthopedics and trauma surgeons in Berlin, Germany (DKOU) 2017.

Funding

There is no funding source.

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Authors and Affiliations

Authors

Contributions

All authors have participated in the research.

Data analysis: CKB, PL, and JB. Interpretation of data: CKB, JB, SW, and PL. Drafting of manuscript: CKB, JB, and PL. Critical review and writing of the manuscript: CKB, JB, SH, and PL. Approval of final version of the manuscript: all authors.

Corresponding author

Correspondence to Christoph Kolja Boese.

Ethics declarations

Conflict of interest

CKB is an employee of Smith & Nephew GmbH. The other authors declare no relevant conflict of interest.

Ethical approval and informed consent

The study protocol followed the principles of the Declaration of Helsinki and following the local ethics committee, no formal informed consent was required for this retrospective analysis.

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Boese, C.K., Wilhelm, S., Haneder, S. et al. Influence of calibration on digital templating of hip arthroplasty. International Orthopaedics (SICOT) 43, 1799–1805 (2019). https://doi.org/10.1007/s00264-018-4120-7

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  • DOI: https://doi.org/10.1007/s00264-018-4120-7

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