Surroca Maria, Miguela Silvia, Bartra-Ylla Agustí, Nuñez Jorge H, Angles-Crespo Francesc
Hip Unit, Department of Orthopedic Surgery, Fundació Assistencial Mútua Terrassa, Terrassa, Spain.
Department of Surgery, Universitat de Barcelona, Barcelona, Spain.
Hip Pelvis. 2024 Jun 1;36(2):129-134. doi: 10.5371/hp.2024.36.2.129.
Preoperative planning has become essential in performance of total hip arthroplasty (THA). However, data regarding the effect of the planner's experience on the accuracy of digital preoperative planning is limited. The objective of this study was to assess the accuracy of digital templating in THA based on the surgeon's experience.
A retrospective study was conducted. An analysis of 98 anteroposterior pelvic radiographs, which were individually templated by four surgeons (two hip surgeons and two orthopaedic residents) using TraumaCad digital planning, was performed. A comparison of preoperatively planned sizes with implanted sizes was performed to evaluate the accuracy of predicting component size. The results of preoperative planning performed by hip surgeons and orthopaedic residents were compared for testing of the planner's experience.
Femoral stem was precisely predicted in 32.4% of cases, acetabular component in 40.3%, and femoral offset in 76.7%. Prediction of cup size showed greater accuracy than femoral size among all observers. No differences in any variable were observed among the four groups (acetabular cup =0.07, femoral stem =0.82, femoral offset =0.06). All measurements showed good reliability (intraclass correlation coefficient [ICC] acetabular cup: 0.76, ICC femoral stem: 0.79).
The results of this study might suggest that even though a surgeon's experience supports improved precision during the planning stage, it should not be restricted only to surgeons with a high level of experience. We consider preoperative planning an essential part of the surgery, which should be included in training for orthopaedics residents.
术前规划已成为全髋关节置换术（THA）实施过程中的关键环节。然而，关于规划者经验对数字术前规划准确性影响的数据有限。本研究旨在基于外科医生的经验评估THA中数字模板的准确性。
进行一项回顾性研究。对98张骨盆前后位X线片进行分析，这98张X线片由四位外科医生（两位髋关节外科医生和两位骨科住院医师）分别使用TraumaCad数字规划软件进行模板测量。将术前规划的尺寸与植入的尺寸进行比较，以评估预测假体组件尺寸的准确性。比较髋关节外科医生和骨科住院医师术前规划的结果，以检验规划者的经验。
在32.4%的病例中股骨柄得到精确预测，髋臼组件为40.3%，股骨偏心距为76.7%。在所有观察者中，髋臼杯尺寸的预测比股骨尺寸的预测更准确。四组之间在任何变量上均未观察到差异（髋臼杯=0.07，股骨柄=0.82，股骨偏心距=0.06）。所有测量均显示出良好的可靠性（组内相关系数[ICC]，髋臼杯：0.76，股骨柄：0.79）。
本研究结果可能表明，尽管外科医生的经验有助于在规划阶段提高精确性，但不应仅局限于经验丰富的外科医生。我们认为术前规划是手术的重要组成部分，应纳入骨科住院医师的培训内容。
