Increased Accuracy in Templating for Total Knee Arthroplasty Using 3D Models Generated from Radiographs.

Area of Science:

• Orthopedic Surgery
• Medical Imaging
• Biomedical Engineering

Background:

• Preoperative templating in total hip arthroplasty improves surgical efficiency.
• Predicting implant size in total knee arthroplasty (TKA) can enhance operating room efficiency.
• Current 2D digital templating methods have limitations in accuracy for TKA implant size prediction.

Purpose of the Study:

• To compare the accuracy of TKA templating using 2D digital radiographs versus a novel 3D imaging technology.
• To evaluate the effectiveness of 3D templating in predicting femoral and tibial component sizes.

Main Methods:

• Retrospective analysis of 202 robotic-assisted primary TKA cases using Persona Knee System.
• Preoperative 3D templating using a novel radiographic image acquisition protocol.
• Comparison with 2D digital templating using the same radiographs; surgeons were blinded to final implant sizes.

Main Results:

• The 3D imaging technology achieved higher accuracy in predicting both tibial (99.5%) and femoral (84%) component sizes compared to attending surgeons (87% and 77%, respectively).
• The 3D technology predicted the exact tibial component size in 93.1% of cases, significantly outperforming residents (40%) and attending surgeons (53%).
• Both 2D and 3D templating methods were more accurate for tibial than femoral components, with a tendency to overestimate femoral size.

Conclusions:

• The novel 3D imaging technology offers superior accuracy in TKA implant size prediction compared to traditional 2D templating.
• Improved accuracy in implant size prediction has the potential to enhance intraoperative efficiency, reduce costs, and minimize surgical time.
• This 3D templating approach represents a significant advancement for optimizing TKA procedures.