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Related Experiment Video

Updated: May 20, 2025

Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
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Two-Dimensional Preoperative Digital Templating is Less Accurate When Using a Collared Triple Taper Stem Versus a

Claudio Diaz-Ledezma1, Angel X Xiao1, Juan David Lizcano2

  • 1Department of Orthopedic Surgery, University of California San Francisco, San Francisco, CA, USA.

Arthroplasty Today
|March 25, 2025
PubMed
Summary
This summary is machine-generated.

Templating accuracy for Collared Triple Taper Stems (CTTS) in total hip arthroplasty is lower than Single Taper Stems (STS). CTTS often requires a smaller implant size than templated, suggesting improved 3D templating may be beneficial.

Keywords:
TemplatingTotal hip arthroplastyTriple taper stems

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Radiology

Background:

  • Collared Triple Taper Stems (CTTS) and Single Taper Stems (STS) demonstrate excellent performance in primary total hip arthroplasty (THA).
  • While 2D radiographic templating is accurate for STS, data for CTTS accuracy is limited.
  • The anatomical design of CTTS may impact templating precision.

Purpose of the Study:

  • To compare the templating accuracy of CTTS against the predecessor STS in THA.
  • To evaluate if the anteroposterior design of CTTS influences templating size prediction.
  • To assess the reliability of digital templating for predicting final implant size for both stem types.

Main Methods:

  • A comparative study of 106 THA cases using CTTS and 106 THA cases using STS.
  • All procedures were performed by high-volume surgeons using stems from the same manufacturer and identical templating software.
  • Medial-lateral profile and size range were consistent between the compared stems.

Main Results:

  • Direct template-to-stem accuracy was lower for CTTS (36.8%) compared to STS (49.1%).
  • CTTS implants were more frequently undersized (2+ sizes) compared to STS (10.4% vs 2.8%).
  • Stem type was the sole predictor for implants being 2 or more sizes smaller than templated.

Conclusions:

  • Conventional 2D templating accuracy for CTTS is inferior to STS, often overestimating required stem size.
  • The frequent undersizing of CTTS suggests potential limitations of current templating methods.
  • Bi-planar or 3D preoperative templating may offer improved accuracy for CTTS, particularly during the learning curve.