Intra- and inter-operator reliability of three-dimensional preoperative planning in total knee arthroplasty.
Details
Serval ID
serval:BIB_E3665BE675C7
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Intra- and inter-operator reliability of three-dimensional preoperative planning in total knee arthroplasty.
Journal
Archives of orthopaedic and trauma surgery
ISSN
1434-3916 (Electronic)
ISSN-L
0936-8051
Publication state
Published
Issued date
08/2024
Peer-reviewed
Oui
Volume
144
Number
8
Pages
3625-3630
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Abstract
To characterize the intra- and inter-operator reliability of a CT-based 3D preoperative planning software.
This study analyzed 30 CT scans of de-identified knees with osteoarthritis. For each scan, a case planner segmented the bones and pre-planned the TKA. Three orthopedic surgeons then reviewed each pre-planning three times at least one week apart, in a blinded manner. During the reviews, the surgeons modified the pre-plannings until they felt the plannings matched the objectives defined collegially at the beginning of the study. Reliability was assessed using the Intraclass Correlation Coefficient (ICC) and the Standard Error of Measurement (SEM).
The intra- and inter-operator reliabilities for implant size selection were almost perfect (ICC between 0.97 and 0.99). Implants of same sizes were selected in 67.1-90.0% of cases. For implant placements, almost perfect intra- and inter-operator reliability was observed in all degrees-of-freedom (ICC between 0.81 and 1.00), except in flexion-extension for the femur (intra-operator ICC between: 0.76 and 0.99; inter-operator ICC of 0.61) and the tibia (intra-operator ICC between 0.12 and 1.00; inter-operator ICC of 0.03). All implant placements SEM were below 1.3 mm or 1.7°.
This study showed high intra- and inter-operator reliability for implant size selection and, in most of the degrees-of-freedom, also for implant placements. Further research is needed to evaluate the benefit of developing more precise means of describing the objectives of the surgical planning as well as to evaluate the possibility and relevance of adding features in the planning software to assist the operators.
This study analyzed 30 CT scans of de-identified knees with osteoarthritis. For each scan, a case planner segmented the bones and pre-planned the TKA. Three orthopedic surgeons then reviewed each pre-planning three times at least one week apart, in a blinded manner. During the reviews, the surgeons modified the pre-plannings until they felt the plannings matched the objectives defined collegially at the beginning of the study. Reliability was assessed using the Intraclass Correlation Coefficient (ICC) and the Standard Error of Measurement (SEM).
The intra- and inter-operator reliabilities for implant size selection were almost perfect (ICC between 0.97 and 0.99). Implants of same sizes were selected in 67.1-90.0% of cases. For implant placements, almost perfect intra- and inter-operator reliability was observed in all degrees-of-freedom (ICC between 0.81 and 1.00), except in flexion-extension for the femur (intra-operator ICC between: 0.76 and 0.99; inter-operator ICC of 0.61) and the tibia (intra-operator ICC between 0.12 and 1.00; inter-operator ICC of 0.03). All implant placements SEM were below 1.3 mm or 1.7°.
This study showed high intra- and inter-operator reliability for implant size selection and, in most of the degrees-of-freedom, also for implant placements. Further research is needed to evaluate the benefit of developing more precise means of describing the objectives of the surgical planning as well as to evaluate the possibility and relevance of adding features in the planning software to assist the operators.
Keywords
Humans, Arthroplasty, Replacement, Knee/methods, Tomography, X-Ray Computed/methods, Imaging, Three-Dimensional/methods, Reproducibility of Results, Female, Observer Variation, Male, Aged, Osteoarthritis, Knee/surgery, Osteoarthritis, Knee/diagnostic imaging, Preoperative Care/methods, Middle Aged, Implant placement, Implant size selection, Preoperative planning, Reliability, Total knee arthroplasty
Pubmed
Web of science
Open Access
Yes
Create date
19/07/2024 14:10
Last modification date
01/10/2024 7:07