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Updated: Mar 1, 2026

Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty

Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty

Published on: February 27, 2018

Three-Dimensional Templating for Acetabular Component Alignment During Total Hip Arthroplasty.

Ameer M Elbuluk, Paul Wojack, Nima Eftekhary

|May 31, 2017

Summary

Accurate acetabular cup placement in total hip arthroplasty is crucial for implant success. Three-dimensional templating aids in achieving optimal cup positioning, improving prosthesis survival and reducing dislocation risks.

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Area of Science:

Orthopedic Surgery
Biomedical Engineering
Radiology

Background:

Acetabular cup malposition in total hip arthroplasty (THA) compromises implant stability and longevity.
Increased dislocation rates are associated with poorly positioned acetabular components.

Purpose of the Study:

To evaluate the efficacy of 3-dimensional (3D) templating in achieving accurate acetabular component placement during THA.
To assess the role of 3D planning in optimizing prosthesis survival and minimizing dislocation risks.

Main Methods:

Computed tomography (CT)-based analysis of 93 patients undergoing primary THA with computer-assisted navigation.
3D planning utilized to template acetabular components at 40° inclination and 20° anteversion.
Acetabular cup coverage assessed using a clock face reference with the transverse acetabular ligament (TAL) at 6-o'clock.

Main Results:

Significant variations in acetabular cup coverage were observed, with common uncovering between 9- to 1-o'clock (right hips) and 11- to 3-o'clock (left hips).
The most lateral aspect of the cup frequently positioned at 1-o'clock (74% of hips).
Acetabular component alignment relative to the TAL showed 76% aligned, 16% retroverted, and 8% anteverted.

Conclusions:

3D templating provides a valuable intraoperative reference tool for standardizing acetabular cup positioning in THA.
This method enhances accuracy without requiring additional equipment or reliance on complex anatomical landmarks.
Improved acetabular component placement can lead to better implant outcomes and reduced complications.