Two-Dimensional Preoperative Digital Templating is Less Accurate When Using a Collared Triple Taper Stem Versus a Single Taper Design

IF 1.5 Q3 ORTHOPEDICS

Arthroplasty Today Pub Date : 2025-03-11 DOI:10.1016/j.artd.2025.101658

Claudio Diaz-Ledezma MD , Angel X. Xiao MD, MSE , Juan David Lizcano MD , Erik N. Hansen MD , Camilo Restrepo MD , William J. Hozack MD

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引用次数: 0

Abstract

Background

Collared triple taper stems (CTTS) and single taper stems (STS) have an excellent performance in primary total hip arthroplasty (THA). While 2-dimensional radiographic templating is accurate for STS, data are lacking for CTTS. We hypothesize that CTTS’ more anatomical design in the anteroposterior dimension may lead to inaccurate templating sizing. This study compared templating accuracy of CTTS to a predecessor STS in THA patients.

Methods

106 THA performed with CTTS were compared to 106 THA performed with STS by 2 high-volume surgeons. The stems chosen for comparison were manufactured by the same company, use the same templating software, shared an identical medial-lateral profile, and offered the same size range. The ability of digital templating to predict final implant size was evaluated.

Results

Template to stem accuracy was 36.8% for CTTS and 49.1% for STS (P = .07). Accuracy within 1 size was 88.7% for CTTS versus 95.2% for STS (P = .1). CTTS was implanted using a smaller size compared to the template twice as frequently as STS (43.4% vs 20.8%; P < .01). CTTS was 3.7 times more likely to have implants 2 or more sizes under the template compared to STS (10.4% vs 2.8%; P = .02). In logistic regression, the only predictor of implant 2+ sizes under the template was type of stem (P = .04).

Conclusions

The accuracy of conventional templating for CTTS is lower than the predecessor STS, with the template often suggesting a larger size. Bi-planar or 3-dimensional preoperative templating could potentially be a more accurate technique, especially during the initial learning curve with these stems.

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二维术前数字模板在使用带圈的三锥度杆与单锥度设计时精度较低

有领三锥度假体（CTTS）和单锥度假体（STS）在初次全髋关节置换术（THA）中表现优异。虽然二维射线照相模板对STS是准确的，但对CTTS缺乏数据。我们假设CTTS在前后尺寸上的更多解剖设计可能导致不准确的模板尺寸。本研究比较了CTTS与前代STS在THA患者中的模板准确性。方法将2位大容量外科医生106例CTTS THA与106例STS THA进行比较。选择用于比较的阀杆由同一家公司制造，使用相同的模板软件，具有相同的中外侧轮廓，并提供相同的尺寸范围。评估了数字模板预测最终种植体大小的能力。结果CTTS的stemplate to stem准确率为36.8%，STS为49.1% （P = 0.07）。CTTS在1个尺寸内的准确率为88.7%，而STS为95.2% （P = 0.1）。与模板相比，CTTS使用更小的尺寸植入的频率是STS的两倍(43.4% vs 20.8%；P & lt;. 01)。CTTS在模板下植入2个或更多尺寸的植入物的可能性是STS的3.7倍(10.4% vs 2.8%；P = .02)。在逻辑回归中，模板下种植体2+大小的唯一预测因子是茎的类型（P = .04）。结论CTTS常规模板的准确性低于前代STS，模板尺寸往往较大。双平面或三维术前模板可能是一种更准确的技术，特别是在这些茎的初始学习曲线期间。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Arthroplasty Today Medicine-Surgery

CiteScore

2.90

自引率

0.00%

发文量

258

审稿时长

40 weeks

期刊介绍： Arthroplasty Today is a companion journal to the Journal of Arthroplasty. The journal Arthroplasty Today brings together the clinical and scientific foundations for joint replacement of the hip and knee in an open-access, online format. Arthroplasty Today solicits manuscripts of the highest quality from all areas of scientific endeavor that relate to joint replacement or the treatment of its complications, including those dealing with patient outcomes, economic and policy issues, prosthetic design, biomechanics, biomaterials, and biologic response to arthroplasty. The journal focuses on case reports. It is the purpose of Arthroplasty Today to present material to practicing orthopaedic surgeons that will keep them abreast of developments in the field, prove useful in the care of patients, and aid in understanding the scientific foundation of this subspecialty area of joint replacement. The international members of the Editorial Board provide a worldwide perspective for the journal''s area of interest. Their participation ensures that each issue of Arthroplasty Today provides the reader with timely, peer-reviewed articles of the highest quality.