Christian Ries1, Christoph Tobias Baltin2, Stefan Haneder3, Peer Eysel2, Martin Hellmich4, Christoph Kolja Boese5,6. 1. Division of Orthopaedics, Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany. 2. Department of Orthopaedic and Trauma Surgery, University Hospital of Cologne, Joseph-Stelzmann-Str. 24, 50931, Cologne, Germany. 3. Department of Diagnostic and Interventional Radiology, University Hospital Cologne, Kerpener Str. 62, 50931, Cologne, Germany. 4. IMSB, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany. 5. Department of Orthopaedic and Trauma Surgery, University Hospital of Cologne, Joseph-Stelzmann-Str. 24, 50931, Cologne, Germany. k.boese@uke.de. 6. Division of Orthopaedics, Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany. k.boese@uke.de.
Abstract
PURPOSE: Accuracy of calibration of radiographs significantly influences the quality of digital templating for total hip arthroplasty (THA). The standard of care is calibration with external calibration markers (ECM). This method is associated with significant errors. Dual-scale single marker (DSSM) calibration methods may improve accuracy. The present prospective observational study is the first to analyze the application of a DSSM method in standing pelvis radiographs. METHODS: 100 patients with unilateral THA underwent antero-posterior pelvis radiographs with ECM and DSSM. The hip components were used as reference calibration factor (internal calibration factor; ICM). Absolute differences of calibration factors for ECM and DSSM from ICM were calculated. Absolute relative deviations (ARD) were calculated. Subgroup analysis for sex and WHO BMI category was performed. Furthermore, patients reported subjective comfort for each marker using a 10-point scale and choosing the preferred marker. RESULTS: Maximum magnification factor differences from the ICM were 23.3% and 9.5% and mean absolute differences were 12.5% and 2.1% for the ECM and DSSM, respectively. ARD from ICM was significantly lower for DSSM compared to ECM (p < 0.001). Absolute differences increased with BMI category using ECM; calibration by DSSM was consistent in all subgroups. Patients preferred DSSM over ECM (n = 53) or were indifferent (n = 20). Comfort was rated significantly higher for DSSM versus ECM (p < 0.001). CONCLUSION: DSSM method showed superior results in comparison to the ECM method for calibration of digital radiographs. DSSM could be used to improve digital templating in standing radiographs.
PURPOSE: Accuracy of calibration of radiographs significantly influences the quality of digital templating for total hip arthroplasty (THA). The standard of care is calibration with external calibration markers (ECM). This method is associated with significant errors. Dual-scale single marker (DSSM) calibration methods may improve accuracy. The present prospective observational study is the first to analyze the application of a DSSM method in standing pelvis radiographs. METHODS: 100 patients with unilateral THA underwent antero-posterior pelvis radiographs with ECM and DSSM. The hip components were used as reference calibration factor (internal calibration factor; ICM). Absolute differences of calibration factors for ECM and DSSM from ICM were calculated. Absolute relative deviations (ARD) were calculated. Subgroup analysis for sex and WHO BMI category was performed. Furthermore, patients reported subjective comfort for each marker using a 10-point scale and choosing the preferred marker. RESULTS: Maximum magnification factor differences from the ICM were 23.3% and 9.5% and mean absolute differences were 12.5% and 2.1% for the ECM and DSSM, respectively. ARD from ICM was significantly lower for DSSM compared to ECM (p < 0.001). Absolute differences increased with BMI category using ECM; calibration by DSSM was consistent in all subgroups. Patients preferred DSSM over ECM (n = 53) or were indifferent (n = 20). Comfort was rated significantly higher for DSSM versus ECM (p < 0.001). CONCLUSION: DSSM method showed superior results in comparison to the ECM method for calibration of digital radiographs. DSSM could be used to improve digital templating in standing radiographs.