Digital templating for THA planning; efficiency and accuracy improves with institutional familiarity

Area of Science:

• Orthopaedic Surgery
• Medical Imaging
• Surgical Planning

Background:

• Pre-operative templating is essential for total hip arthroplasty (THA) planning.
• Accurate templating enhances surgical efficiency, precision, and reduces complications.
• Incorrect scaling ball placement leads to magnification and templating errors.

Purpose of the Study:

• To evaluate the impact of scaling ball (SB) positioning accuracy on digital templating for THA.
• To assess if templating accuracy improves with increased familiarity with the system over time.
• To identify factors influencing SB positioning accuracy.

Main Methods:

• Review of digital radiographs from 211 primary THA cases.
• Comparison of two consecutive sets of digitally templated radiographs.
• Assessment of scaling ball (SB) positioning as ideal or non-ideal.

Main Results:

• Significant improvement in SB positioning accuracy over time (70% vs 30.7%, p < 0.0001).
• Ideal SB placement correlated with more accurate acetabular component templating (44.2% vs 27.3% exact measurement, p=0.008).
• Improved SB accuracy observed when the fat apron is absent (p=0.042).

Conclusions:

• Accurate scaling ball positioning in the coronal plane enhances digital templating accuracy for both acetabular and femoral components.
• Ongoing education for surgical, nursing, and radiography teams is vital for optimizing templating.
• Improved SB positioning accuracy contributes to overall efficiencies in THA planning and preparation.