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Preoperative planning of primary total hip arthroplasty using conventional radiographs

Objective: The aim of this study was to present an analog method for preoperative planning of primary total hip arthroplasty procedures based on component measurements by overlaying the transparency of the prosthesis on preoperative radiographs and checking the accuracy, both for predicting the size of the acetabular and femoral components to be used and to restore offset and correct dysmetria if any. Methodology: From May 2019 to June 2022, 18 primary total hip arthroplasties were performed and were analyzed in 18 patients at the Post graduate Department of Orthopaedics GMC Srinagar. Measurements on femoral and acetabular components obtained by planning were compared to those used in surgery. Displacements measured through preoperative planning was compared with planning measured on postoperative radiographs. Dysmetria was assessed before and after surgery. Results: accuracy of 68.5% ( p <0.001) in predicting the size of the acetabular component and 74.3% ( p <0.001) in femoral nail prediction was observed. Displacements measured through preoperative planning was statistically similar to offsets measured postoperatively in radiographs. After surgery, we recorded absolute settlement in 42.5% of cases. In 81.8% the dysmetria was less than or equal to 1 cm and in 51.3% it was less than or equal to up to 0.5 cm. Conclusions: Accuracy was 68.5% and 74.3% for acetabular and femoral components. Preoperatively planned offsets were statistically similar to as measured on postoperative radiographs. We found absolute alignment in 42.5% cases.