Preoperative Templating In Total Hip Replacement

Hip arthroplasty is a surgical technique that encompasses the replacement of the diseased
hip joint with a prosthetic implant. Individuals with massive hip joint decay have
acquired many benefits from this procedure. Hemiarthroplasty is another procedure that
involves the replacement of the affected half of the joints with the prosthesis while the
other healthy half of the joint has remained unaltered. Even though researchers have
revealed that total hip arthroplasty offers better results than hemiarthroplasty (Parker,
Gurusamy & Azegami, 2010)
The most common indication of total hip replacement is osteoarthritis. A displaced
fracture of the femoral neck that happens in younger patients is furthermore an important
indication. Extra main indications include rheumatoid arthritis, juvenile, hip fractures,
ankylosing spondylitis, benign and malignant bone tumors, and Paget’s disease. Total
hip arthroplasty is likewise recommended for the controlling of unrestrained
traumatic dislocation of the hip joint which is very common in developing
countries (Bartoníček, Skála-Rosenbaum, Džupa & Douša, 2005)
Alike any other procedure, total hip replacement also has its complications. Dislocation
is considered one of the most common complications, moreover, it rises because the hip
ball can get dislocated from its socket throughout the first 2 to 3 months subsequently to
the operation. Venous thrombosis after hip arthroplasty is a major problem that disturbs
surgeons. On the other hand, this can be dealt with through thromboprophylaxis (Garrett,
Epstein, Harris, Harvey & Nickel, 1979)
Metal sensitivity can lead to implant failure in a metal prosthesis, and this must be
suspected in patients who reveal the cutaneous signs of allergy after implantation
of a metal device (Austin, Higuera & Rothman, 2012)
Osteolysis, Sciatic nerve palsy, and the two legs discrepancy are among other
complications that are worth mentioning (Garrett, Epstein, Harris, Harvey & Nickel,
1979)
Preoperative planning plays a crucial role in the success of any surgical procedure. In hip
arthroplasty, the preoperative assessment shows various aspects of the procedure are of
extreme importance. Researches have revealed that unplanned hip replacement
procedures have lower success rates than planned ones. A prospective study was carried
out at the University of Pennsylvania, which has shown that unplanned and urgent hip
arthroplasty led to a longer hospital stay of the patient and increased the patient’s
financial burden (Mikhael, Hanssen & Sierra, 2009).
Preoperative planning of hip arthroplasty has shown promising results in determining the
appropriate size of the prosthesis that has to be used in the procedure. Preoperative
templating guarantees an inordinate degree of hip implant procedures success. Precisely
allocating the size of the template increases the care of the procedure. Preoperative
templating reduces the chance of implant loosening over time. Moreover, exact
templating before a total hip replacement has revealed an important impact in reducing
the complications of the procedure among peri-prothetic fractures, and leg length
discrepancy (Hallab, Merritt & Jacobs, 2001).
References:
1. Parker MJ, Gurusamy KS, Azegami S. Arthroplasties (with and without bone
cement) for proximal femoral fractures in adults. The Cochrane database of
systematic reviews. 2010; 6:CD001706.
https://doi.org/10.1002/14651858.CD001706.pub4
2. Skala-Rosenbaum J, Cech O, Dzupa V. [Arthroplasty for intracapsular fractures
of the femoral neck. Current concept review]. Acta chirurgiae orthopaedicae et
traumatologiae Cechoslovaca. 2012; 79(6):484-92. PMid:23286679
3. Garrett JC, Epstein HC, Harris WH, Harvey JP Jr, Nickel VL. Treatment of
unreduced traumatic posterior dislocations of the hip. J Bone Joint Surg Am.
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PMid:23874255 PMCid:PMC3715633
5. Mikhael MM, Hanssen AD, Sierra RJ. Failure of metal-on-metal total hip
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