Christoph Kolja Boese1, Sebastian Wilhelm2, Stefan Haneder3, Philipp Lechler4, Peer Eysel2, Jan Bredow5,6. 1. Department of Orthopaedic and Trauma Surgery, University Hospital of Cologne, Joseph-Stelzmann-Str. 9, 50924, Cologne, Germany. christoph.boese@uk-koeln.de. 2. Department of Orthopaedic and Trauma Surgery, University Hospital of Cologne, Joseph-Stelzmann-Str. 9, 50924, Cologne, Germany. 3. Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Cologne, Germany. 4. Center of Orthopedic and Trauma Surgery, University of Giessen and Marburg, Marburg, Germany. 5. Department of Spine Surgery, Schön Klinik Düsseldorf, Düsseldorf, Germany. 6. Center for Orthopedics, Schön Klinik Düsseldorf SE & Co. KG, Am Heerdter Krankenhaus 2, 40549, Düsseldorf, Germany.
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.
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.
Entities:
Keywords:
Calibration; Digital templating; Radiography; Total hip arthroplasty
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