Three-dimensional templating in hip arthroplasty: the basis for template-directed instrumentation?

Area of Science:

• Orthopedic surgery
• Medical imaging
• Biomechanical engineering

Background:

• Computed tomography (CT)-based 3D models offer potential for precise pre-operative planning in total hip arthroplasty (THA).
• Accurate determination of rotational centers, femoral offsets, and implant sizing is crucial for successful THA outcomes.
• Evaluating the accuracy of anatomical reconstruction using 3D planning tools is essential for clinical application.

Purpose of the Study:

• To evaluate the accuracy of anatomical reconstruction using a 3D planning tool for total hip arthroplasty.
• To assess the precision of determining key parameters like center of rotation and femoral offsets.
• To validate the templated implant size against actual surgical implantation.

Main Methods:

• Eight hip arthroplasties were performed on four bilateral cadaver specimens.
• CT scans were utilized to create 3D models for pre-operative templating.
• Prosthesis position and size were meticulously planned based on individual anatomical conditions.

Main Results:

• All evaluated parameters were reconstructed with an average accuracy of 4.5 mm.
• The achieved accuracy was within the limits recommended in existing literature.
• All implanted prostheses matched the size determined during the templating phase.

Conclusions:

• 3D templating software enables precise analysis of patient anatomy and required prosthesis size and position.
• The findings support the development of template-directed instrumentation for THA.
• Further advancements, including navigation or robotic assistance, may be necessary to enhance implant positioning precision.