Common errors in the execution of preoperative templating for primary total hip arthroplasty

Area of Science:

• Orthopedic Surgery
• Radiographic Analysis
• Surgical Planning

Background:

• Total hip arthroplasty (THA) aims to restore joint function and patient mobility.
• Limb length discrepancy and femoral offset changes are common complications impacting THA outcomes.
• Preoperative templating is essential for accurate component placement and surgical planning.

Purpose of the Study:

• To evaluate the accuracy of preoperative templating in total hip arthroplasty.
• To identify common errors in templating and their impact on limb length and femoral offset.
• To assess the reliability of different radiographic measurements for limb length discrepancy.

Main Methods:

• Review of 75 primary total hip arthroplasty (THA) preoperative and postoperative radiographs.
• Analysis of limb length discrepancy, femoral offset, acetabular position, neck cut, and femoral component positioning.
• Comparison of interobturator, interteardrop, and intertuberosity lines for measuring limb length discrepancy.

Main Results:

• The interobturator line demonstrated the least variance in measuring preoperative limb length discrepancy.
• Excessive limb lengthening (mean, 3.52 mm) was the most frequent templating error, linked to inferior acetabular cup positioning.
• Incomplete acetabular component medialization was the primary cause of femoral offset discrepancy.

Conclusions:

• Preoperative templating errors in THA commonly lead to excessive limb lengthening and increased offset.
• Inferior acetabular cup positioning is a key factor in limb lengthening errors.
• Improved identification of these templating errors can enhance surgical accuracy and patient outcomes.