The precision and accuracy of templating the size of unicondylar knee arthroplasty (original) (raw)
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Reliability of templating in estimating the size of uni-condylar knee arthroplasty
The Journal of Arthroplasty, 2003
The use of template systems has aided the preoperative selection of correct prosthetic size during routine arthroplasty. A similar system exists for unicondylar knee arthroplasty. Our goal is to assess the reliability of these templates for preoperatively predicting the correct prosthetic size in unicompartmental knee systems. Ten observers estimated the size of the unicondylar knee prosthesis required for 30 randomly selected patients with osteoarthritis. Estimation of the size was gauged using templates and instructions provided by the manufacturer. The observers worked independently and repeated their measurements 2 weeks later. Intraobserver and interobserver agreement was evaluated using the weighted coefficient, and this revealed poor agreement regardless of the surgeon's experience. This shows that the present system lacks reliability and raises concerns about the place for preoperative radiological templating in unicompartmental knee arthroplasty.
Reliability of preoperative measurement with standardized templating in Total Knee Arthroplasty
World journal of orthopedics, 2013
To investigate the correlation between preoperative measurement in total knee arthroplasty and the prosthetic size implanted. A prospective double-blind study of 50 arthroplasties was performed. Firstly, the reliability and correspondence between the size of said measurement and the actual implant utilized was determined. Secondly, the existing correlation between the intra- and interobserver determinations with the intraclass correlation coefficient was analyzed. An overall correspondence of 54%, improving up to 92% when the measured size admitted a difference of one size, was found. Good intra- and interobserver reliability with an intraclass correlation coefficient greater than 0.90 (P < 0.001) was also discovered. Agreement between the preoperative measurement with standardized acetate templates and the prosthetic size implanted can be considered satisfactory. We thus conclude it is a reproducible technique.
The accuracy of preoperative templating in total knee arthroplasty
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2007
Radiographic templates have been developed to assist with the preoperative planning process. However, the clinical usefulness of preoperative templating in total knee replacement is still lacking. The present study aims to evaluate the accuracy of preoperative templating in primary total knee replacement. A retrospective study of 98 patients and 113 knees was carried out. Both the anteroposterior and lateral radiographic views were templated using the templates for DePuy Sigma PFC, fixed bearing total knee system and the template size was documented for each patient pre-operatively. The operative records were then reviewed to determine the size of the implant used during the operation. The overall accuracy between the preoperative template size and the final implant size was 50.4% for the femoral component and 55.8% for the tibial component. The highest prediction for tibial assessment was the anteroposterior view and the lateral intercondylar view for femoral assessment. Approximat...
Accuracy of knee implants sizing predicted by digital images
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2009
Accurate preoperative templating to predict implant size and position can facilitate precise, efficient, and reproducible knee replacement operations. Preoperative templating for total knee arthroplasty can be performed with digital images of the knee implants on digital radiographs of the knee. To determine the accuracy of knee implants sizing predicted by digital images. A retrospective study was done to assess the accuracy of the knee implant sizing predicted by digital images in 100 Thai adults, who had osteoarthritis of the knee. Digital anteroposterior and lateral radiographs of the knee were used in measuring the level of distal femoral resection and the level of proximal tibial resection. Anteroposterior and mediolateral diameter of femur and tibia were determined and the implant size was choosen. The results from digital images were compared with the size of actual femoral and tibial implants used at the time of surgery. All variables were analyzed. The correlation coeffici...
Arthroplasty Today, 2020
Background: Accurate sizing is critical for the overall success of a total knee arthroplasty (TKA). This study's primary purpose was to investigate the ability to predict the tibial and femoral component size in a single implant system from patient demographics and anthropometric data. A secondary goal was to compare the predicted tibial and femoral component sizes from our statistical model with a previously validated electronic application used to predict the implant size. Methods: A consecutive series of 484 patients undergoing a primary TKA at a single institution was reviewed. Data on height, weight, body mass index, sex, age, and component size were collected. A proportional odds model was developed to predict tibial and femoral component sizes. The relationship between the proportional odds model predictions was also compared with the component sizes determined by the Arthroplasty Size Predictor electronic application. Results: Weight, height, and sex predicted the implanted component size with an accuracy of 54.0% (n ¼ 247/484) for the tibia and 51.1% (n ¼ 231/484) for the femur. The accuracy improved to 94.4% (n ¼ 457/ 484) for the tibia and 93.4% (n ¼ 452/484) for the femur within ±1 component size. Our data are highly correlated to the Arthroplasty Size Predictor for the predicted tibial component size (r ¼ 0.91, P < .001) and femoral component size (r ¼ 0.89, P < .001). Conclusions: Our novel templating model may improve operative efficiency for a single TKA system. Our findings have a high concordance with a widely available electronic application used to predict implant sizes for a variety of TKA systems.
Advances in Orthopedics, 2021
Background. Knee arthroplasty surgeries are in ever-increasing demand. With unicompartmental knee arthroplasty (UKA), patients may benefit from a higher range of flexion and a better Knee Society Score (KSS). Aim. In this study, we compared the short-term clinical outcomes of total knee arthroplasty (TKA) and UKA using the patient-specific templating (PST) technique. Methods. Two groups of 20 knees each were divided into UKA and TKA groups depending on the Oxford criteria of UKA. Only patients with medial compartmental osteoarthritis were included. KSS, functional knee score (FKS), and ROF were assessed preoperatively and at 6 months postoperatively. Results. The TKA group has shown a significant improvement compared to the UKA group in KSS (MD = 39.35 vs. 31.2, respectively, p = 0.003 ). Both TKA and UKA have shown no significant difference concerning both the FKS (MD = 32 and 31.75, respectively, p = 0.926 ) and ROF (MD = 10.25 and 7.25, respectively, p = 0.072 ). Discussion. The ...
Orthopedics, 2012
The use of digital radiography and templating software continues to become more prevalent in orthopedics as the number of total hip arthroplasty (THA) and total knee arthroplasty (TKA) procedures increases every year. The purpose of this study was to evaluate the effect of training level on the accuracy of digital templating for primary THA and TKA. Digital radiographs of 97 patients undergoing primary THA (49 cases) and TKA (48 cases) were retrospectively templated using OrthoView digital planning software (OrthoView LLC, Jacksonville, Florida). Anteroposterior hip and lateral knee radiographs were digitally templated and compared to the actual size of the implants used at the time of surgery. An implant sales representative, physician assistant, medical student, resident, and fellowship-trained arthroplasty surgeon [AQ 2] templated all cases independently after a standardized orientation and were blinded to the actual component sizes used for surgery. The medical student, resident, and arthroplasty surgeon re-templated the same 97 cases 1 month later to determine intraobserver reliability.
Pre-operative templating for knee arthroplasty shows low accuracy with standard X-rays
International orthopaedics, 2018
The purpose of this study was to evaluate the accuracy and reliability of pre-operative templating in predicting the size of femoral and tibial components and the effect of coronal deformity on templating accuracy. This was a retrospective study of 39 pre-operative templates prepared by three different surgeons with different levels of training. The accuracy and reliability measures were evaluated by alpha and kappa coefficients of agreement. The analysis of the effect of coronal deformity on the accuracy of the template was measured by the Spearman's correlation test. Templating was accurate for the femoral component in 28.21% of anterposterior (AP) radiographs and 35.90% of lateral radiographs. Kappa coefficients were respectively 0.111 (95% confidence interval [95%CI]: -0.19 to 0.241) and 0.200 (95%CI: -0.010 to 0.401), indicating poor agreement. Templating accuracy for the tibial component were, respectively, 37.61% and 47.01% for AP and lateral views. Kappa coefficients wer...
Computer assisted orthopedic surgery; its influence on prosthesis size in total knee replacement
The Knee, 2008
Improvement of alignment and position of the components in TKAs using Computer Assisted Orthopaedic Surgery (CAOS) has been described. However, much less is known about the accuracy of CAOS in determining the size of the components. The purpose of this study was to evaluate the size of the femoral and tibial component using the CAOS system from Brainlab. The component sizes were compared to pre-operative templating and post-operative scoring the adequateness of size. Forty TKAs (NexGen) were evaluated: 20 using CAOS and 20 conventional. Statistical analysis of the templated and implanted size indicated a fair agreement for the femur (kappa 0.38) and the tibia (kappa 0.35). In the CAOS group significantly more oversizing occurred for the femoral component (p = 0.020). No significant difference was found for the tibial component. We conclude there is a risk of oversizing the femoral component of the NexGen system when using CAOS.
Prospective Validation of a Demographically Based Primary Total Knee Arthroplasty Size Calculator
Journal of Arthroplasty, 2019
± 2 sizes of predicted, the tibial accuracy was 97% (461/474) and the femoral accuracy was 95% (450/474). Risk factors for the actual components falling outside of 2 predicted sizes include weight less than 70-kg [odds ratio (OR) = 2.47, 95% CI (1.21-5.06), p = 0.01] and use of an implant system with < 2.5 mm incremental changes between femoral sizes [OR = 5.50, 95% CI (3.33-9.11), p < 0.001]. Conclusion: This prospective series of patients validates a simple algorithm to predict component sizing for TKA with high accuracy based on demographic variables alone. Surgeons can use this algorithm to simplify the pre-operative planning process by reducing unnecessary trays, trials, and implant storage, particularly in the community or outpatient setting where resources are limited. Further assessment of components with less than 2.5mm differences between femoral sizes is required in the future to make this algorithm more applicable worldwide.