Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.)...
Transcript of Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.)...
![Page 1: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/1.jpg)
Preoperative Hip X-rays : Templating
Dr. (Prof.) Anil AroraMS (Ortho) DNB (Ortho) Dip SIROT
(USA)FAPOA (Korea), FIGOF (Germany),
FJOA (Japan)Commonwealth Fellow Joint
Replacement (Royal National Orthopaedic Hospital,
London, UK)
Senior Knee and Hip Replacement Surgeon
Associate DirectorDepartment of Orthopaedics and
Joint ReplacementMax Superspeciality Hospital,
Patparganj, Delhi (India)E-mail :
![Page 2: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/2.jpg)
![Page 3: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/3.jpg)
Purposes of Templating
Preoperative planning
– Forces surgeon to think in 3 dimensions
–Assists surgical team in preparing instruments
–Ensures adequate inventory of implants
–May help predict complications during surgery and needs that might arise
![Page 4: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/4.jpg)
Why Template ?
• Facilitates the surgical goals of
restoration of hip biomechanics in
terms of
Limb length
Offset
Center of rotation
![Page 5: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/5.jpg)
Advantages of Templating
• Match the opposite side > Unilateral hip disease
• In contralateral THR match the previous
• Marked discrepancy from template indicates component malpositioning, malsizing or an iatrogenic occult fracture.
![Page 6: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/6.jpg)
FOUR STEPS of Templating
• Evaluating the Quality of Radiograph
• Identifying Anatomical Landmarks
• Defining Mechanical References
• Choice and Positioning of Implants
![Page 7: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/7.jpg)
Magnification of the film shall match
the desired magnification, as
mentioned on the template !
![Page 8: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/8.jpg)
To Template an Xray (for THR)
◙ Have the desired magnification.
◙ Reference for Measurements
![Page 9: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/9.jpg)
![Page 10: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/10.jpg)
Limb length Discrepancy
Offset
Acetabular Templating
Femoral Templating
Centre of rotation (COR)
![Page 11: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/11.jpg)
Radiologic Limb length Discrepancy
Fixed point on Pelvis to a fixed point on
Femur
Inter tear drop line to fixed point on the
Lesser Trochanter.
Look for:
True Discrepancy
Apparent LLD
![Page 12: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/12.jpg)
![Page 13: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/13.jpg)
![Page 14: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/14.jpg)
![Page 15: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/15.jpg)
![Page 16: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/16.jpg)
![Page 17: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/17.jpg)
Acetabular Templating
• Component size
• Position
• Centre of rotation
• Mark the Centre of Rotation
![Page 18: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/18.jpg)
450
Acetabular Templating
![Page 19: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/19.jpg)
ACETABULAR TEMPLATING
AP View Pelvis
• Acetabular Size
• Center of Rotation
![Page 20: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/20.jpg)
![Page 21: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/21.jpg)
![Page 22: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/22.jpg)
![Page 23: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/23.jpg)
![Page 24: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/24.jpg)
What is Femoral Offset ?
Perpendicular distance
between the
“center of the femoral
head”
and a
“line drawn down the
center of the femoral
shaft”
![Page 25: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/25.jpg)
Femoral Offset Measurement
Anatomically is distance between Long axis of Femur and Center of Head
• Tip of Greater Trochanter to Centre of femoral
head.
or
• Saddle to Centre of femoral head.
![Page 26: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/26.jpg)
H
V
![Page 27: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/27.jpg)
![Page 28: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/28.jpg)
![Page 29: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/29.jpg)
![Page 30: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/30.jpg)
![Page 31: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/31.jpg)
Choose OFFSET
• Aim is to match it with the opposite
side.
• Centre of femoral head should match
Centre of rotation of hip after relocation
• Has immense clinical importance
![Page 32: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/32.jpg)
![Page 33: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/33.jpg)
![Page 34: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/34.jpg)
![Page 35: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/35.jpg)
![Page 36: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/36.jpg)
Femoral component
• Should template the opposite side also
• Template Femoral canal for Size
• Choose Neck Length to reproduce
Femoral Offset and Leg Length .
• Mark Centre of Femoral Head
• Determine the Level of neck osteotomy
![Page 37: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/37.jpg)
Canal Type (Calcar to Canal Ratio)
![Page 38: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/38.jpg)
CALCARTO
CANALRATIO
Canal Type
![Page 39: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/39.jpg)
Type A
Type CType B
CC : 0.5CC : 0.5 to 0.75
CC : >0.75
![Page 40: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/40.jpg)
![Page 41: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/41.jpg)
![Page 42: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/42.jpg)
Cementless stem
Proximal Coating
Adjust template
sizes until optimal
contact between
the lateral and
medial endosteal
cortex of the
proximal femur is
achieved
![Page 43: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/43.jpg)
Fully Coated Cementless
Look for throughout fill down
upto medullary canal
Cemented stem
Adjust template sizes to allow
for an adequate cement
mantle of 2-3mm
![Page 44: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/44.jpg)
FEMORAL TEMPLATING
Stem Size
Offset
Neck Resection level
Neck length
![Page 45: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/45.jpg)
![Page 46: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/46.jpg)
.
![Page 47: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/47.jpg)
Adjustments
• Limb Length
Discrepancy
• Offset
• Neck Length
![Page 48: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/48.jpg)
![Page 49: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/49.jpg)
...
![Page 50: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/50.jpg)
![Page 51: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/51.jpg)
Full Profile in both views
![Page 52: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/52.jpg)
![Page 53: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/53.jpg)
• Mark osteophytes
• Mark cysts
• Observe protrusio acetabuli–to
lateralize the cup for better
biomechanics and reduce
impingement.
![Page 54: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/54.jpg)
Accuracy of Templating
• Predicts more than 80% of
intraoperative difficulties
• Acetabular size predictability > femoral
side predictability
• Accuracy lower for uncemented
implants
![Page 55: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/55.jpg)
![Page 56: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/56.jpg)
OFFSET
• Coxa vara - lower the neck cut and
increase offset
• Opposite for coxa valga
• Doubtful cases cut the neck longer and
than adjust
![Page 57: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/57.jpg)
VARUS Hip
VALGUS Hip
![Page 58: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/58.jpg)
LARGE Offset
![Page 59: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/59.jpg)
Mental Templating
![Page 60: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/60.jpg)
![Page 61: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/61.jpg)
![Page 62: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/62.jpg)
![Page 63: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/63.jpg)
![Page 64: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/64.jpg)
![Page 65: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/65.jpg)
![Page 66: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/66.jpg)
![Page 67: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/67.jpg)
![Page 68: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/68.jpg)
![Page 69: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/69.jpg)
![Page 70: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/70.jpg)
![Page 71: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/71.jpg)
![Page 72: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/72.jpg)
![Page 73: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/73.jpg)
![Page 74: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/74.jpg)
![Page 75: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/75.jpg)
THANKS
![Page 76: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/76.jpg)
Thank You
![Page 77: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/77.jpg)
![Page 78: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/78.jpg)
![Page 79: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/79.jpg)
![Page 80: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/80.jpg)
![Page 81: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/81.jpg)
![Page 82: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/82.jpg)
![Page 83: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/83.jpg)
![Page 84: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/84.jpg)
. .
![Page 85: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/85.jpg)
. .
![Page 86: Preoperative Hip X-rays : Templating Total Hip...Preoperative Hip X-rays : Templating Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany),](https://reader034.fdocuments.us/reader034/viewer/2022042210/5eaeeed0e64d9f602210f6e0/html5/thumbnails/86.jpg)