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Interobserver and Intraobserver Reliability of Three-Dimensional Preoperative Planning Software in Total Hip
Yasushi Wako1, Junichi Nakamura1, Michiaki Miura1
1Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Chiba City, Chiba, Japan.
Insights
Three-dimensional (3D) templating for total hip arthroplasty (THA) demonstrates excellent reliability in component size and alignment. However, joint deformity can impact preoperative planning accuracy.
Area of Science:
- Orthopedic Surgery
- Medical Imaging
- Biomechanical Engineering
Background:
- Accurate preoperative planning is crucial for successful total hip arthroplasty (THA).
- Three-dimensional (3D) templating using computed tomography (CT) offers detailed anatomical visualization.
- Understanding the reliability of 3D templating is essential for its clinical application.
Purpose of the Study:
- To assess the interobserver and intraobserver reliability of 3D templating in total hip arthroplasty (THA).
- To evaluate how hip morphology, specifically osteoarthritis (OA) versus osteonecrosis (ON), affects templating reliability.
Main Methods:
- Preoperative CT scans from 60 primary THA cases were used for 3D templating.
- Six orthopedic surgeons performed templating twice over a 4-week interval.
- Intraclass correlation coefficients (ICCs) and percent agreement were calculated for component size and alignment.
Main Results:
- Excellent interobserver reliability was found for cup (ICC = 0.907) and stem size (ICC = 0.944).
- Interobserver and intraobserver reliabilities were higher in the osteonecrosis (ON) group compared to the osteoarthritis (OA) group.
- Severe hip subluxation in OA cases reduced the reliability of cup size and alignment planning.
Conclusions:
- CT-based 3D templating demonstrates high reliability for component size and alignment in THA.
- Preoperative planning reliability is influenced by the degree of joint deformity.
- 3D templating is a dependable tool for THA preoperative planning, with considerations for complex hip morphologies.
Background:
The purpose of this study is to clarify interobserver and intraobserver reliabilities of the three-dimensional (3D) templating of total hip arthroplasty (THA).
Methods:
We selected preoperative computed tomography from 60 hips in 46 patients (14 men and 32 women) who underwent primary THA. To evaluate interobserver and intraobserver reliability, 6 orthopedic surgeons performed 3D templating twice over a 4-week interval. We investigated intraclass correlation coefficients (ICCs) and percent agreement of component size and alignment, comparing morphological differences in the hip. Reproducibility was also compared between groups with osteoarthritis (OA) and those with osteonecrosis (ON).
Results:
The interobserver reliabilities for mean cup size and stem size were excellent, with ICC = 0.907 and 0.944, respectively. The value was significantly higher in the ON group than in the OA group. In the OA group, the reliability of cup size and alignment decreased in hips with severe subluxation. Percent agreement of stem size was significantly different between the shapes of femoral canal. For intraobserver reliability, the mean ICC of cup size was 0.965 overall, while the value in the ON group was significantly higher than in the OA group. The mean ICC of stem size was 0.972 overall.
Conclusion:
Computed tomography-based 3D templating showed excellent reliability for component size and alignment in THA. Deformity of the affected joint influenced the reliability of preoperative planning.
