Is There Any Difference Between a Spherical Marker and a Simple Coin for Hip Replacement Digital Planning?^[*]

Abstract

Objective To evaluate the accuracy and differences between 2 types of metallic markers, sphere, and coin, for radiographic calibration in the preoperative planning of hip arthroplasty.

Methods Four spherical metallic markers and four coins, both 25 mm in diameter, were placed on the greater trochanter, pubic symphysis, between the thighs, and on the table of the exam, for radiographic examination of the hip in 33 patients with hip prosthesis. The prosthesis head was used for calibration and two examiners measured the markers' image diameters, and the results were analyzed statistically.

Results In the greater trochanter, the sphere and the coin were not visualized in 19 radiographs (57.6%). Between the thighs, the coin marker was not visualized in 13 radiographs (39.4%). In the greater trochanter, the 25-mm accuracy of the coin and the sphere was, respectively, between 57.1 and 63.3% and between 64.3 and 92.9%. The coin between the thighs reached 25-mm accuracy in between 50 and 60% of cases. Over the exam table, the coin and sphere markers reached, respectively, the mean diameters of 22.91 mm and 23 mm, the lowest coefficient of variation, the lowest confidence interval, and the easiest positioning. There was statistical difference between the evaluations of the markers (coin vs. sphere) in all positions (p < 0.032), except for the exam table position (p = 0.083).

Conclusions The coin between the thighs is the best marker for radiographic calibration in the preoperative planning of hip arthroplasty, and we suggest the use of another coin on the exam table for comparison, considering the 8% reduction in relation to its real size.

Keywords

arthroplasty, replacement, hip - hip prosthesis - radiography - pelvis - radiographic magnification

Financial Support

There was no financial support from public, commercial, or non-profit sources.

^* Work performed at the Hip Group of the Department of Orthopedics and Traumatology, Faculdade de Ciências Médicas Santa Casa de Misericórdia de São Paulo (FCMSCSP), São Paulo, SP, Brazil.

Publikationsverlauf

Eingereicht: 03. Juni 2020

Angenommen: 14. Oktober 2020

Artikel online veröffentlicht:
24. Januar 2022

• Referências

• 1 Muller ME. Total hip replacement: planning, technique and complications. In: Surgical management of degenerative arthritis of the lower limb. Philadelphia: Lea and Faber; 1975: 90-113
• 2 Müller ME. Lessons of 30 years of total hip arthroplasty. Clin Orthop Relat Res 1992; (274) 12-21
• 3 Knight JL, Atwater RD. Preoperative planning for total hip arthroplasty. Quantitating its utility and precision. J Arthroplasty 1992; 7 (Suppl): 403-409
• 4 Hoikka V, Paavilainen T, Lindholm TS, Turula KB, Ylikoski M. Measurement and restoration of equality in length of the lower limbs in total hip replacement. Skeletal Radiol 1987; 16 (06) 442-446
• 5 Eggli S, Pisan M, Müller ME. The value of preoperative planning for total hip arthroplasty. J Bone Joint Surg Br 1998; 80 (03) 382-390
• 6 Baghdadi YM, Larson AN, Sierra RJ. Restoration of the hip center during THA performed for protrusio acetabuli is associated with better implant survival. Clin Orthop Relat Res 2013; 471 (10) 3251-3259
• 7 Iorio R, Siegel J, Specht LM, Tilzey JF, Hartman A, Healy WL. A comparison of acetate vs digital templating for preoperative planning of total hip arthroplasty: is digital templating accurate and safe?. J Arthroplasty 2009; 24 (02) 175-179
• 8 Wimsey S, Pickard R, Shaw G. Accurate scaling of digital radiographs of the pelvis. A prospective trial of two methods. J Bone Joint Surg Br 2006; 88 (11) 1508-1512
• 9 Franken M, Grimm B, Heyligers I. A comparison of four systems for calibration when templating for total hip replacement with digital radiography. J Bone Joint Surg Br 2010; 92 (01) 136-141
• 10 Archibeck MJ, Cummins T, Tripuraneni KR. et al. Inaccuracies in the Use of Magnification Markers in Digital Hip Radiographs. Clin Orthop Relat Res 2016; 474 (08) 1812-1817
• 11 Conn KS, Clarke MT, Hallett JP. A simple guide to determine the magnification of radiographs and to improve the accuracy of preoperative templating. J Bone Joint Surg Br 2002; 84 (02) 269-272
• 12 Petretta R, Strelzow J, Ohly NE, Misur P, Masri BA. Acetate templating on digital images is more accurate than computer-based templating for total hip arthroplasty. Clin Orthop Relat Res 2015; 473 (12) 3752-3759
• 13 Gamble P, de Beer J, Petruccelli D, Winemaker M. The accuracy of digital templating in uncemented total hip arthroplasty. J Arthroplasty 2010; 25 (04) 529-532
• 14 Heinert G, Hendricks J, Loeffler MD. Digital templating in hip replacement with and without radiological markers. J Bone Joint Surg Br 2009; 91 (04) 459-462
• 15 González Della Valle A, Comba F, Taveras N, Salvati EA. The utility and precision of analogue and digital preoperative planning for total hip arthroplasty. Int Orthop 2008; 32 (03) 289-294
• 16 The B, Verdonschot N, van Horn JR, van Ooijen PM, Diercks RL. Digital versus analogue preoperative planning of total hip arthroplasties: a randomized clinical trial of 210 total hip arthroplasties. J Arthroplasty 2007; 22 (06) 866-870
• 17 Boese CK, Lechler P, Rose L. et al. Calibration Markers for Digital Templating in Total Hip Arthroplasty. PLoS One 2015; 10 (07) e0128529
• 18 Polesello GC, Nakao TS, Queiroz MC. et al. Proposta de Padronização do Estudo Radiográfico do Quadril e da Pelve. Rev Bras Ortop 2011; 46 (06) 634-642
• 19 Blake CA, van der Merwe J, Raubenheimer JE. A practical way to calibrate digital radiographs in hip arthroplasty. SA Orthop J 2013; 12 (04) 33-37
• 20 Fleiss JL. The design and analysis of clinical experiments. New York: Wiley; 1986
• 21 Altman DG, Bland JM. Measurement in Medicine: The Analysis of Method Comparison Studies. Statistician 1983; 32 (03) 307-317
• 22 Streiner DL, Norman GR. Health measurement scales: a practical guide to their development and use. 2nd ed.. New York: Oxford University Press Inc.; 1995
• 23 The B, Diercks RL, Stewart RE, van Ooijen PM, van Horn JR. Digital correction of magnification in pelvic x rays for preoperative planning of hip joint replacements: theoretical development and clinical results of a new protocol. Med Phys 2005; 32 (08) 2580-2589