Department of Orthopaedic Surgery, Lampang Hospital and Medical Education Center, Lampang, Thailand.
J Arthroplasty. 2021 Jun;36(6):2204-2210. doi: 10.1016/j.arth.2021.01.019. Epub 2021 Jan 15.
Preoperative templating for total hip arthroplasty (THA) on digital radiography can be achieved using templating software or hybrid methods (acetate templates overlaid on digital images). No studies have examined templating with a mobile phone. We evaluated the accuracy and reproducibility of a new digital templating method using the picture archiving and communication system (PACS) and iPhone, compared with the hybrid method for cementless THA.
A total of 113 hip radiographs were retrospectively templated by three observers. For the digital method, a circle was drawn on the acetabulum using PACS to represent the cup. The photograph of the computer screen was taken with an iPhone and imported into the Keynote presentation software. The femoral stem was then templated with transparent digital templates, which had been digitized from acetate templates. For the hybrid method, an acetate template was placed over the onscreen digital radiographs. Templated results were compared with the actual components used.
The digital method was more accurate than the hybrid method to predict ±1 size of femoral stem [93.8% (106 hips) vs 84.1% (95 hips), P = .032] and offset [90.3% (102 hips) vs 75.2% (85 hips), P = .004)]. The accuracies of digital and hybrid techniques were comparable with predict ±1 size for acetabular cup [92.9% (105 hips) vs 89.4% (101 hips), P = .483] and neck length [98.2% (111 hips) vs 96.5% (109 hips), P = .683]. Both techniques had substantial to almost perfect agreement for intraobserver and interobserver reliability.
Digital templating using PACS and iPhone is accurate and reproducible for predicting implant size of cementless THA.
全髋关节置换术（THA）术前在数字 X 射线上进行模板设计，可以使用模板软件或混合方法（在数字图像上叠加醋酸酯模板）来实现。目前还没有研究检查使用手机进行模板设计的情况。我们评估了一种新的数字模板方法在使用图片存档和通信系统（PACS）和 iPhone 方面的准确性和可重复性，与用于非骨水泥 THA 的混合方法进行了比较。
共有 113 例髋关节 X 线片由 3 位观察者进行回顾性模板设计。对于数字方法，在 PACS 上在髋臼上画一个圆圈以表示髋臼杯。用 iPhone 拍摄计算机屏幕的照片，并将其导入 Keynote 演示文稿软件中。然后，使用已从醋酸酯模板数字化的透明数字模板对股骨柄进行模板设计。对于混合方法，将醋酸酯模板放在屏幕上的数字 X 射线上。将模板结果与实际使用的组件进行比较。
数字方法比混合方法更准确地预测股骨柄的±1 尺寸[93.8%（106 髋）比 84.1%（95 髋），P=0.032]和偏心距[90.3%（102 髋）比 75.2%（85 髋），P=0.004]。数字和混合技术的准确性可用于预测髋臼杯的±1 尺寸[92.9%（105 髋）比 89.4%（101 髋），P=0.483]和颈长[98.2%（111 髋）比 96.5%（109 髋），P=0.683]。两种技术在观察者内和观察者间的可靠性方面都具有很大到几乎完美的一致性。
使用 PACS 和 iPhone 的数字模板设计对于预测非骨水泥 THA 的植入物尺寸是准确且可重复的。
