Di Martino A, Rossomando V, Brunello M, D'Agostino C, Pederiva D, Frugiuele J, Pilla F, Faldini C
1st Orthopaedic and Traumatologic Clinic, IRCCS Rizzoli Orthopedic Institute, Via G.C. Pupilli 1, 40136, Bologna, Italy.
Department of Biomedical and Neuromotor Science-DIBINEM, University of Bologna, Bologna, Italy.
Musculoskelet Surg. 2023 Mar;107(1):19-28. doi: 10.1007/s12306-023-00772-3. Epub 2023 Jan 11.
Templating plays a key role in surgery that is often underestimated. There is a difference between planning and templating: in the first not only the hip is considered but involves the evaluation of the patient in its entirety. Templating instead consists of calculating the position of the implant in order to place it in the best possible position. Fundamental is a correct X-ray of the pelvis, which must follow certain standards. For traditional templating, drawings on appropriately enlarged transparent implants were provided by the prosthesis manufacturer. The implementation of digital software into clinical practice has improved the accuracy and reproducibility of templating, which in most surgical units is performed by standard 2D radiographic images. Thanks to digital preoperative templating in a digital radiology environment, the hip reconstructive surgeon can perform preoperative planning and implant sizing quickly, consistently, and affordably. Currently, 3D templating can also be performed by software used initially to create personalized stems for THA. Aim of the current review is to outline the essentials of correct templating in THA performance, and to report the updates since the introduction of digital and 3D technologies in this setting.
模板制作在手术中起着关键作用,而这一点常常被低估。规划和模板制作存在差异:规划不仅要考虑髋关节,还涉及对患者整体的评估。相反,模板制作包括计算植入物的位置,以便将其放置在最佳位置。骨盆的正确X线片至关重要,其必须符合一定标准。对于传统模板制作,假体制造商提供在适当放大的透明植入物上的绘图。数字软件在临床实践中的应用提高了模板制作的准确性和可重复性,在大多数手术科室,模板制作是通过标准的二维放射影像进行的。得益于数字放射学环境中的数字术前模板制作,髋关节重建外科医生能够快速、一致且经济地进行术前规划和植入物尺寸确定。目前,3D模板制作也可通过最初用于为全髋关节置换术创建个性化股骨柄的软件来完成。本综述的目的是概述全髋关节置换术操作中正确模板制作的要点,并报告自该领域引入数字和3D技术以来的进展情况。