Reliability of preoperative templating in total knee arthroplasty

The purpose of this study was to determine the reliability of preoperative templating in primary total knee arthroplasty and the influence of the seniority of the surgeon on templating. A retrospective study of 25 randomly selected total knee replacements was undertaken, with templating of preoperative radiographs by four surgical staff members. These included a consultant, a specialist registrar and two senior house officers. Reliability for an exact match between template size and implant actually used was 49% for the femoral component and 67% for the tibial component. The statistical agreement between templated size and actual implant size was classed as only fair to moderate. There was no statistical difference in templating reliability between junior and senior surgical staff. These results indicate that the current system of templating for total knee arthoplasties is prone to error and can only be used as an approximate guide.