J Korean Orthop Assoc JKOA Journal of the Korean Orthopaedic Association 1226-2102 2005-8918 The Korean Orthopaedic Association 10.4055/jkoa.2011.46.6.472 Original Article Preoperative Templating in PACS for Total Hip Replacement Kim Myoung Soo M.D. Jeong Moo Chul M.D. Ji Nam Gu * Lee Jung Sub M.D. * Kim Jeung Il M.D. * Suh Kuen Tak M.D. * Department of Orthopaedic Surgery, Maryknoll Hospital, Busan, Korea. Department of Orthopaedic Surgery, Pusan National University School of Medicine, Yangsan, Korea. Correspondence to: Kuen Tak Suh, M.D. Department of Orthopaedic Surgery, Pusan National University Yangsan Hospital, Beomeo-ri, Mulgeum-eup, Yangsan 626-770, Korea. TEL: +82-55-360-2125, FAX: +82-55-360-2155, kuentak@pusan.ac.kr 12 2011 29 12 2011 46 6 472 477 20 06 2011 25 10 2011 Copyright © 2011 by The Korean Orthopaedic Association 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

 Purpose

The objective of our study was to compare preoperative "Monitor Templating" with postoperative results for total hip replacement and to investigate the accuracy of "Monitor Templating" that was carried out by monitoring with picture archiving communication system (PACS).

 Materials and Methods

Forty five patients underwent primary cementless total hip replacements. For setting parameters, we located the 10cm rod placed in the medial thigh on anteroposterior view of both hips and in the anterior thigh on Lowenstein lateral view. We measured implant sizes and the predictive value of corrective change in leg length and horizontal offset, by using radiographs magnified 120% of the anteroposterior views of both hips and Lowenstein lateral view of PACS on 27 inch monitor. We examined the correlation between preoperative monitor templating and the actual implant size, postoperative leg length and horizontal offset difference.

 Results

The preoperative monitor templating showed a high rate of coincidence with the actual implant size, the postoperative leg length, and the horizontal offset difference. The averages in accurate prediction were 98% in the acetabular cup, 98% in the femoral stem, 97% in the postoperative actual difference of leg length, and 97% in the horizontal offset. With regard to leg length discrepancy, the sick limb was on average 4.7 mm shorter and 0.5 mm longer postoperatively than the contralateral limb. The average ratio of horizontal offset of the sick limb to the contralateral limb was 94.6% preoperatively and increased to 97.8% postoperatively.

 Conclusion

Preoperative "Monitor Templating" using PACS images on 26 inch monitor is an easy and effective method for predicting implant size, correcting leg length discrepancy and restoring horizontal offset.

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Preoperative "Monitor Templating" for measuring sizes of acetabular cup and femoral stem in 120% magnified radiograph of Lowenstein lateral view in picture archiving communication system on the 27 inch monitor.

Preoperative "Monitor Templating" for measuring sizes of acetabular cup and femoral stem and difference of leg length and horizontal offset in 120% magnified radiograph of anteroposterior view of both hips in picture archiving communication system on the 27 inch monitor.

Exact Prediction between Preoperative Monitor Templating and Postoperative Results

Accurate Prediction between Preoperative Monitor Templating and Postoperative Results

Leg Length Discrepancy & Horizontal Offset Ratio