Accuracy of One-dimensional Templating on Linear EOS Radiography Allows Template-directed Instrumentation in Total Knee Arthroplasty

Overview

Journal J Orthop Surg Res

Publisher Biomed Central

Specialty Orthopedics

Date 2021 Nov 11

PMID 34758860

Citations 1

Authors

Michael Andreas Finsterwald

Salar Sobhi

Senthuren Isaac

Penelope Scott

Riaz J K Khan

Daniel P Fick

Affiliations

Soon will be listed here.

Abstract

Background: Templating for total knee arthroplasty (TKA) is routinely performed on two-dimensional standard X-ray images and allows template-directed instrumentation. To date, there is no report on one-dimensional (1D) anteroposterior (AP) templating not requiring specific templating software. We aim to describe a novel technique and explore its reliability, accuracy and potential cost-savings.

Methods: We investigated a consecutive series of TKAs at one institution between January and July 2019. Patients with preoperative low-dose linear AP EOS radiography images were included. Implant component sizes were retrospectively templated on the AP view with the hospitals imaging viewing software by two observers who were blinded to the definitive implant size. Planning accuracy as well as inter- and intra-observer reliability was calculated. Cost-savings were estimated based on the reduction of trays indicated by the 1D templating size estimations.

Results: A total of 141 consecutive TKAs in 113 patients were included. Accuracy of 1D templating was as follows: exact match in 53% femoral and 63% tibial components, within one size in 96% femoral and 98% tibial components. Overall 58% of TKA components were planned correctly and 97% within one size. Inter- and intra-rater reliability was good (κ = 0.66) and very good (κ = 0.82), respectively. This templating process can reduce instrumentation from six to three trays per case and therefore halve sterilisation costs.

Conclusions: The new 1D templating method using EOS AP imaging predicts component sizes in TKA within one size 97% of the time and can halve the number of instrumentation trays and sterilisation costs.

Citing Articles

The Rationalization of Surgical Trays in Staged Bilateral Lower Limb Arthroplasty: A 10-Year Cohort Study.

Boktor J, Trivedi R, Alshahwani A, Joseph V, Ashry A, Lewis P Cureus. 2024; 16(9):e69665.

PMID: 39429314 PMC: 11488676. DOI: 10.7759/cureus.69665.

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