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. 2023 Aug 7;10(8):939.
doi: 10.3390/bioengineering10080939.

Three-Dimensional Preoperative Planning Software for Hip Resurfacing Arthroplasty

M Abdulhadi Alagha  1 , Kartik Logishetty  1 , Ciaran O'Hanlon  1 , Alexander D Liddle  1 , Justin Cobb  1
Affiliations

Three-Dimensional Preoperative Planning Software for Hip Resurfacing Arthroplasty

M Abdulhadi Alagha et al. Bioengineering (Basel). .

Abstract

Three-dimensional planning of hip arthroplasty is associated with better visualisation of anatomical landmarks and enhanced mapping for preoperative implant sizing, which can lead to a decrease in surgical time and complications. Despite the advantages of hip resurfacing arthroplasty (HRA), it is considered a technically challenging procedure and associated with inaccurate implant placement. This study aimed to examine the validity, reliability, and usability of preoperative 3D Hip Planner software for HRA. Fifty random cases of various hip osteoarthritis severity were planned twice by two junior trainees using the 3D Hip Planner within a one-month interval. Outcome measures included femoral/cup implant size, stem-shaft angle, and cup inclination angle, and were assessed by comparing outcomes from 2D and 3D planning. An adapted unified theory of acceptance and use of technology (UTAUT) survey was used for software usability. Bland-Altman plots between 3D and 2D planning for stem-shaft and inclination angles showed mean differences of 0.7 and -0.6, respectively (r = 0.93, p < 0.001). Stem-shaft and inclination angles showed inter-rater reliability biases of around -2° and 3°, respectively. Chi-square and Pearson's correlation for femoral implant size showed a significant association between the two assessors (r = 0.91, p < 0.001). The 3D test-retest coefficient of repeatability for stem-shaft and inclination angles were around ±2° and ±3°, respectively, with a strong significant association for femoral implant size (r = 0.98, p < 0.001). Survey analyses showed that 70-90% agreed that 3D planning improved expectancy in four domains. 3D hip planner appears to be valid and reliable in preoperative HRA and shows significant potential in optimising the quality and accuracy of surgical planning.

Keywords: 3D planner; arthroplasty; hip resurfacing; preoperative planning.

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Conflict of interest statement

J. Cobb declares grant funding from the Michael Uren Foundation, activity relating to the submitted work; and patents and stocks/stock options for Embody Orthopaedic, activity outside the submitted work.

Figures

Figure 1
Figure 1
3D Hip Planner software.
Figure 2
Figure 2
Visual representation of (a) stem-shaft angle and (b) cup inclination using Embody 3D hip planner software.
Figure 3
Figure 3
The clinical backgrounds of doctors participating in the adapted UTAUT questionnaire.
Figure 4
Figure 4
Limits of agreement for stem-shaft (left) and inclination (right) angles between 3D Hip Planner and 2D templating.
Figure 5
Figure 5
Limits of agreement for stem-shaft (left) and inclination (right) angles between the two assessors.
Figure 6
Figure 6
Test–retest Pearson’s correlation for stem-shaft (left) and inclination (right) angles.
Figure 7
Figure 7
Findings from the adapted UTAUT survey, showing participants’ experience in five domains: performance expectancy, effort expectancy, social influence, facilitating conditions, and attitudes toward 3D planning.
Figure 8
Figure 8
The adapted UTAUT model for 3D hip planning.
See this image and copyright information in PMC

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