Accuracy of digital templating of uncemented total hip arthroplasty at a certified arthroplasty center: a retrospective comparative study

Abstract

Introduction: To investigate the accuracy of preoperative digital templating for total hip arthroplasty (THA) at a certified arthroplasty center (EndoCert EPZmax). Materials and methods: In a retrospective study design, we analysed 620 uncemented primary THAs for templating accuracy by comparing the preoperatively planned THA component size and the implanted size as documented by the surgeon. Templating was determined to be a) exact if the planned and the implanted component were the same size and b) accurate if they were exact ± one size. Moreover, we investigated factors that potentially influence templating accuracy: overweight and obesity (WHO criteria), sex, implant design, surgeon experience, preoperative diagnosis. Digital templating was done with MediCAD software. The Mann–Whitney U test and the Kruskal–Wallis test were used for statistical analysis. Results: Templating was exact in 52% of stems and 51% of cups and was accurate in 90% of the stems and 85% of the cups. Regarding the factors potentially influencing templating accuracy, the type of cup implant had a significant influence (p = 0.016). Moreover, greater accuracy of stem templating was achieved in female patients (p = 0.004). No such effect was determined for the other factors investigated. Conclusions: We conclude that preoperative 2D templating is accurate in 90% of the stems and 85% of the cups. Greater accuracy may be achieved in female patients. In addition to gender, the type of implant used may influence planning accuracy as well. Surgeon experience, BMI and preoperative diagnosis did not influence templating accuracy. Level of evidence: Level III (retrospective comparative study with prospective cohort).