Observational studyArchives of orthopaedic and trauma surgery2023
Imprecise prediction of implant sizes with preoperative 2D digital templating in total knee arthroplasty.
Observational study in Archives of orthopaedic and trauma surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- 3D imaging-based AI models outperform demographic models and excel in tibial sizing compared with 2D models in total knee arthroplasty planning: A systematic review.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Pooled it
- Consistently high accuracy of digital 2D templating in total knee arthroplasty across different levels of surgical training.Arthroplasty (London, England) · 2026Article
- A deep learning based automatic two-dimensional digital templating model for total knee arthroplasty.Knee surgery & related research · 2024Article
- Role of Image-Free Robotic-Assisted Technology in Enhancing Accuracy of Implant Sizing for Total Knee Arthroplasty.Cureus · 2024Article
- Development of an artificial intelligence model for predicting implant size in total knee arthroplasty using simple X-ray images.Journal of orthopaedic surgery and research · 2024Article
- The accuracy of preoperative implant size prediction achieved by digital templating in total knee arthroplasty is not affected by the quality of lateral knee radiographs.Journal of experimental orthopaedics · 2024Article
- Predictability of implant sizes during cruciate-retaining total knee arthroplasty using an image-free hand-held robotic system.Journal of robotic surgery · 2024Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo analyze the match between preoperatively determined implant size (2D templating) and intraoperatively used implant size in total knee arthroplasty (TKA). Also examined were the factors that might influence templating accuracy (gender, surgeon experience, obesity, etc.). MATERIALS AND
methodsThe study was retrospective and conducted in a specialized ENDOCERT arthroplasty center. Digital templating was done with the MediCAD software. If the planned and implanted TKA components (both femur and tibia) were the same size, the match was classified "exact." A deviation of ± one size (at the femur or tibia or both) was classified "accurate." A deviation of ± two or more sizes (at the femur or tibia or both) was classified "inaccurate." Obesity, gender, implant type and surgeon experience were investigated for potential influence on templating accuracy. Chi-square tests and Cohen's weighted kappa test were used for statistical analysis.
resultsA total of 482 cases [33.6% male, 66.4% female, age 69 ± 11, body mass index (BMI) 30.3 ± 5.8] were included. When the femur and tibia were taken together, exact size match was observed in 34% (95% CI 29.9-38.3%) of cases, accurate size match in 57.5% (95% CI 53-61.8%) and inaccurate size match in 8.5% (95% CI 6.3-11.2%). Inaccurate size match prolonged operative time (p = 0.028). Regarding the factors potentially influencing templating accuracy, only gender had a significant influence, with templating being more accurate in men (p = 0.004). BMI had no influence on accuracy (p = 0.87). No effect on accuracy was observed for implant type and surgeon experience.
conclusionsThe accuracy of 2D size templating in TKA is low, even in a specialized ENDOCERT arthroplasty center. The study findings challenge the usefulness of preoperative 2D size templating and highlight the importance of more reliable templating methods. LEVEL OF EVIDENCE: Level III (retrospective observational study).
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