Estudio de la concordancia de un sistema de planificación preoperatoria digital en artroplastia total de cadera / Study of the consistency of a system for preoperative planning digital in total arthroplasty of the hip

Objetivo. Comprobar el grado de concordancia de un sistema informático de planificación preoperatoria, en comparación con el resultado final en la radiografía postoperatoria. Material y método. Se analizaron 55 implantes de prótesis total de cadera. Se utilizó un programa informático de planificación comercializado NETEOUS(R) (Socinser(R), Gijón, España). La valoración de la concordancia se realizó calculando el índice Kappa para el tipo de vástago o el índice de concordancia de Lin para el resto de medidas: talla de vástago y cotilo; cuello protésico; y distancia desde el centro de rotación a trocánter menor. También se describieron los porcentajes de aciertos. Resultados. Tamaño de vástago: el acierto exacto o con error de solo una talla fue del 61,6%; cuantitativamente fue un Lin de 0,64 (sustancial). Offset horizontal: se obtuvo una concordancia satisfactoria (índice de Kappa de 0,75). En 6 casos (10,90%) se cambió a lateralizado durante la cirugía, para obtener mayor estabilidad articular. Tamaño del cotilo: la concordancia obtenida fue de 0,67 (sustancial) con un grado de aciertos del 43,6%. Longitud del cuello protésico: los aciertos exactos o con error de solo una talla se hallaron en un 50,9%, nivel de concordancia moderada. Distancia del centro de rotación a trocánter menor: se apreció una concordancia casi perfecta con un Lin de 0,95. El porcentaje de aciertos exactos o con discrepancia inferior a 5mm fue del 74,5%. Discusión y conclusión. En nuestras manos el sistema informático de planificación preoperatoria analizado ha proporcionado índices de concordancia aceptables al compararlo con el resultado postoperatorio. No obstante, hacen falta trabajos que sean verificados por observadores independientes (AU)

Objective. Check the agreement of a preoperative digital templating, compared with the final result in the postoperative radiograph. Material and method. The study was carried out on a 55 total hip prosthesis. A templating-software Neteous(R) (Socincer(R), Gijón, Spain) was used. Agreement was measured using the Kappa Index for the stem offset or Lin Index for others variables: stem size, cup size, femoral neck length, and the distance from the center of rotation of the femoral head to the lesser trochanter. The percentage of accurate hits was also described. Results. Stem size: The exact success or error of only one size was of 61.6%. Quantitatively the Lin Index was 0.64 (substantial). Horizontal offset: satisfactory agreement was obtained (Kappa index of 0.75). In 6 cases (10.90%) was changed to lateralized during surgery, for more joint stability. Size of the cup: the agreement obtained was 0.67 (substantial) with a hit grade of 43.6%. Prosthetic neck length: the exact hit or error of only one size were found in 50.9%, moderate level of agreement. Distance from the center of rotation to the lesser trochanter: was observed for almost perfect agreement with Lin Index of 0.95. The exact percentage of hits or gap error less than 5mm was 74.5%. Discussion and conclusion. In ours hands, the preoperative templating software analyzed, has provided acceptable agreement rates, when compared with the postoperative result. But it takes more works verified by independent observers (AU)

[Study of the consistency of a system for preoperative planning digital in total arthroplasty of the hip]. / Estudio de la concordancia de un sistema de planificación preoperatoria digital en artroplastia total de cadera.

OBJECTIVE: Check the agreement of a preoperative digital templating, compared with the final result in the postoperative radiograph. MATERIAL AND METHOD: The study was carried out on a 55 total hip prosthesis. A templating-software Neteous (Socincer, Gijón, Spain) was used. Agreement was measured using the Kappa Index for the stem offset or Lin Index for others variables: stem size, cup size, femoral neck length, and the distance from the center of rotation of the femoral head to the lesser trochanter. The percentage of accurate hits was also described. RESULTS: Stem size: The exact success or error of only one size was of 61.6%. Quantitatively the Lin Index was 0.64 (substantial). Horizontal offset: satisfactory agreement was obtained (Kappa index of 0.75). In 6 cases (10.90%) was changed to lateralized during surgery, for more joint stability. Size of the cup: the agreement obtained was 0.67 (substantial) with a hit grade of 43.6%. Prosthetic neck length: the exact hit or error of only one size were found in 50.9%, moderate level of agreement. Distance from the center of rotation to the lesser trochanter: was observed for almost perfect agreement with Lin Index of 0.95. The exact percentage of hits or gap error less than 5mm was 74.5%. DISCUSSION AND CONCLUSION: In ours hands, the preoperative templating software analyzed, has provided acceptable agreement rates, when compared with the postoperative result. But it takes more works verified by independent observers.