Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
International Orthopaedics
Published in: International Orthopaedics 4/2017

01-04-2017 | Original Paper

Radiographic templating of total hip arthroplasty for femoral neck fractures

Authors: Dror Lakstein, Ira Bachar, Ronen Debi, Omri Lubovsky, Ornit Cohen, Zachary Tan, Ehud Atoun

Published in: International Orthopaedics | Issue 4/2017

Login to get access

Abstract

Purpose

The purpose of this study was to evaluate the use of pre-operative digital templating to minimize complications including limb length discrepancy (LLD), intraoperative fractures and early dislocations in patients with intracapsular femoral neck fractures.

Methods

We retrospectively compared 23 patients undergoing total hip arthroplasty (THA) for intracapsular femoral fractures with pre-operative digital templating and 48 patients without templating.

Results

The mean post-operative LLD was significantly lower in patients who had pre-operative templating than in the control group (6.7 vs. 11.5 mm, p = 0.023). Only three patients (13 %) with templating had LLD greater than 1.5 cm, compared to the 15 patients (31 %) without templating (p = 0.17). In eight cases the final femoral stem size matched the templated size, while 19 patients were within two size increments. Complications included one dislocation and one intra-operative fracture in the control group.

Conclusion

The present study demonstrated that careful pre-operative planning may reduce LLD in patients undergoing THA due to intracapsular hip fractures.
Literature
1.
Eggli S, Pisan M, Müller ME (1998) The value of preoperative planning for total hip arthroplasty. J Bone Joint Surg (Br) 80(3):382–390CrossRef
2.
Knight JL, Atwater RD (1992) Preoperative planning for total hip arthroplasty. Quantitating its utility and precision. J Arthroplasty 7(Suppl):403–409CrossRefPubMed
3.
Della Valle AG, Padgett DE, Salvati EA (2005) Preoperative planning for primary total hip arthroplasty. J Am Acad Orthop Surg 13(7):455–462CrossRefPubMed
4.
Carter LW, Stovall DO, Young TR (1995) Determination of accuracy of preoperative templating of noncemented femoral prostheses. J Arthroplasty 10(4):507–513CrossRefPubMed
5.
Woolson ST, Hartford JM, Sawyer A (1999) Results of a method of leg-length equalization for patients undergoing primary total hip replacement. J Arthroplasty 14(2):159–164CrossRefPubMed
6.
Crooijmans HJ, Laumen AM, van Pul C, van Mourik JB (2009) A new digital preoperative planning method for total hip arthroplasties. Clin Orthop Relat Res 467(4):909–916CrossRefPubMed
7.
Bertz A, Indrekvam K, Ahmed M, Englund E, Sayed-Noor AS (2012) Validity and reliability of preoperative templating in total hip arthroplasty using a digital templating system. Skeletal Radiol 41(10):1245–1249CrossRefPubMed
8.
Schmidutz F, Steinbrück A, Wanke-Jellinek L, Pietschmann M, Jansson V, Fottner A (2012) The accuracy of digital templating: a comparison of short-stem total hip arthroplasty and conventional total hip arthroplasty. Int Orthop 36(9):1767–1772CrossRefPubMedPubMedCentral
9.
Efe T, El Zayat BF, Heyse TJ, Timmesfeld N, Fuchs-Winkelmann S, Schmitt J (2011) Precision of preoperative digital templating in total hip arthroplasty. Acta Orthop Belg 77(5):616–621PubMed
10.
Whiddon DR, Bono JV, Lang JE, Smith EL, Salyapongse AK (2011) Accuracy of digital templating in total hip arthroplasty. Am J Orthop (Belle Mead NJ) 40(8):395–398
11.
Brew CJ, Simpson PM, Whitehouse SL, Donnelly W, Crawford RW, Hubble MJ (2012) Scaling digital radiographs for templating in total hip arthroplasty using conventional acetate templates independent of calibration markers. J Arthroplasty 27(4):643–647CrossRefPubMed
12.
Choi JK, Geller JA, Wang W, Nyce JD, Macaulay W (2011) The accuracy and reliability of preoperative templating for metal-on-metal hip resurfacing. J Arthroplasty 26(5):765–770CrossRefPubMed
13.
Steinberg EL, Shasha N, Menahem A, Dekel S (2010) Preoperative planning of total hip replacement using the TraumaCad™ system. Arch Orthop Trauma Surg 130(12):1429–1432CrossRefPubMed
14.
Gamble P, de Beer J, Petruccelli D, Winemaker M (2010) The accuracy of digital templating in uncemented total hip arthroplasty. J Arthroplasty 25(4):529–532CrossRefPubMed
15.
Lecerf G, Fessy MH, Philippot R (2009) Femoral offset: anatomical concept, definition, assessment, implications for preoperative templating and hip arthroplasty. Orthop Traumatol Surg Res 95(3):210–219CrossRefPubMed
16.
Iorio R, Siegel J, Specht LM, Tilzey JF, Hartman A, Healy WL (2009) A comparison of acetate vs digital templating for preoperative planning of total hip arthroplasty. Is digital templating accurate and safe? J Arthroplasty 24(2):175–179CrossRefPubMed
17.
Unnanuntana A, Wagner D, Goodman SB (2009) The accuracy of preoperative templating in cementless total hip arthroplasty. J Arthroplasty 24(2):180–186CrossRefPubMed
18.
Hofmann AA, Bolognesi M, Lahav A, Kurtin S (2008) Minimizing leg-length inequality in total hip arthroplasty: use of preoperative templating and an intraoperative X-ray. Am J Orthop (Belle Mead NJ) 37(1):18–23
19.
Della Valle A, Slullitel G, Piccaluga F, Salvati E (2005) The precision and usefulness of preoperative planning for cemented and hybrid primary total hip arthroplasty. J Arthroplasty 20(1):51–58CrossRef
20.
Fottner A, Steinbruck A, Sadoghi P, Mazoochian F, Jansson V (2011) Digital comparison of planned and implanted stem position in total hip replacement using a program form migration analysis. Arch Orthop Trauma Surg 131(7):1013–1019CrossRefPubMed
21.
Jassim SS, Ingham C, Keeling M, Wimhurst JA (2012) Digital templating facilitates accurate leg length correction in total hip arthroplasty. Acta Orthop Belg 78:344–349PubMed
22.
Kniesel B, Konstantinidis L, Hirschmüller A, Südkamp N, Helwig P (2014) Digital templating in total knee and hip replacement: an analysis of planning accuracy. Int Orthop 38(4):733–739CrossRefPubMed
23.
Baker RP, Squires B, Gargan MF, Bannister GC (2006) Total hip arthroplasty and hemiarthroplasty in mobile, independent patients with a displaced intracapsular fracture of the femoral neck. A randomized, controlled trial. J Bone Joint Surg Am 88(12):2583–2589PubMed
24.
Blomfeldt R, Törnkvist H, Eriksson K, Söderqvist A, Ponzer S, Tidermark J (2007) A randomised controlled trial comparing bipolar hemiarthroplasty with total hip replacement for displaced intracapsular fractures of the femoral neck in elderly patients. J Bone Joint Surg (Br) 89(2):160–165CrossRef
25.
Keating JF, Grant A, Masson M, Scott NW, Forbes JF (2006) Randomized comparison of reduction and fixation, bipolar hemiarthroplasty, and total hip arthroplasty. Treatment of displaced intracapsular hip fractures in healthy older patients. J Bone Joint Surg Am 88(2):249–260PubMed
26.
Macaulay W, Nellans KW, Garvin KL, Iorio R, Healy WL, Rosenwasser MP (2008) Prospective randomized clinical trial comparing hemiarthroplasty to total hip arthroplasty in the treatment of displaced femoral neck fractures: winner of the Dorr Award. J Arthroplasty 23(6 Suppl 1):2–8CrossRefPubMed
27.
National Institute for Health and Care Excellence (2011) Hip fracture: the management of hip fracture in adults. CG124 (2011). National Institute for Health and Care Excellence, London
28.
Dorr LD, Glousman R, Hoy AL, Vanis R, Chandler R (1986) Treatment of femoral neck fractures with total hip replacement versus cemented and noncemented hemiarthroplasty. J Arthroplasty 1(1):21–28CrossRefPubMed
29.
Rubash HE, Parvataneni HK (2007) The pants too short, the leg too long: leg length inequality after THA. Orthopedics 30(9):764–765PubMed
30.
Ezzet KA, McCauley JC (2014) Use of intraoperative X-rays to optimize component position and leg length during total hip arthroplasty. J Arthroplasty 29(3):580–585CrossRefPubMed
31.
Conn KS, Clarke MT, Hallett JP (2002) A simple guide to determine the magnification of radiographs and to improve the accuracy of preoperative templating. J Bone Joint Surg (Br) 84(2):269–272CrossRef
32.
Keršič M, Dolinar D, Antolič V, Mavčič B (2013) The impact of leg length discrepancy on clinical outcome of total hip arthroplasty: comparison of four measurement methods. J Arthroplasty 29(1):137–141PubMed
33.
Tsai TY, Dimitriou D, Li G, Kwon YM (2014) Does total hip arthroplasty restore native hip anatomy? Three-dimensional reconstruction analysis. Int Orthop 38(8):1577–1583CrossRefPubMedPubMedCentral
34.
Charnley J (1979) Low friction arthroplasty of the hip. Springer Verlag, Berlin, pp 134–139, 246CrossRef
35.
Sproul RC, Reynolds HM, Lotz JC, Ries MD (2007) Relationship between femoral head size and distance to lesser trochanter. Clin Orthop Relat Res 461(461):122–124PubMed
Metadata
Title
Radiographic templating of total hip arthroplasty for femoral neck fractures
Authors
Dror Lakstein
Ira Bachar
Ronen Debi
Omri Lubovsky
Ornit Cohen
Zachary Tan
Ehud Atoun
Publication date
01-04-2017
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 4/2017
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-016-3235-y

Other articles of this Issue 4/2017

International Orthopaedics 4/2017 Go to the issue

Original Paper

Intramuscular myxoma: clinical and surgical observation notes on eleven cases

Original Paper

Incidence and risk factors for the misplacement of pedicle screws in scoliosis surgery assisted by O-arm navigation—analysis of a large series of one thousand, one hundred and forty five screws

Editorial

Imperfection leads to progress

Original Paper

Risk factors for tibial implant malpositioning in total knee arthrosplasty—consecutive series of one thousand, four hundred and seventeen cases

Original Paper

Safe placement of lateral mass screw in the subaxial cervical spine: a case series

Original Paper

A descriptive study of potential effect of anterior tibial translation, femoral tunnel and anterior cruciate ligament graft inclination on clinical outcome and degenerative changes