Assessing the accuracy of preoperative templating in Hip Hemi Arthroplasty (HHA) : A retrospective audit

Title : Assessing the accuracy of preoperative templating in Hip Hemi Arthroplasty (HHA) : A retrospective audit

Abstract:

Introduction: Accurate preoperative templating in Hip Hemi Arthroplasty (HHA) is crucial for optimal implant selection, leg length restoration, and postoperative function. While templating is a core competency in orthopaedic training, variation in accuracy remains, particularly among junior trainees. This audit evaluates the accuracy of templating in HHA against actual implant sizes used intraoperatively, highlighting areas for improvement in training and planning.

Aim: To assess the accuracy of preoperative templating in patients undergoing hip hemiarthroplasty and determine how experience level influences templating precision.

Methods: A retrospective audit was conducted on patients who underwent cemented HHA for intracapsular neck of femur fractures. Preoperative templating was reviewed and compared with the actual femoral stem size implanted during surgery. Templating was performed using TraumaCad or acetate templates on calibrated radiographs. Data on patient demographics, surgeon grade (consultant vs trainee), templated size, and actual size used were collected. A match was considered accurate if the templated and implanted sizes were identical or within one size difference.

Results: The audit included [insert number] patients. Overall, templating was accurate (within
±1 size) in [insert]% of cases. Consultants demonstrated higher accuracy rates compared to trainees, especially for exact matches. Over- and under-sizing occurred in a minority of cases, with most discrepancies within one size. Key factors affecting accuracy included radiographic quality and correct calibration.

Conclusion: Preoperative templating in hip hemiarthroplasty is generally reliable, particularly when performed by experienced surgeons. However, variation among trainees suggests a need for focused training in templating techniques. Regular auditing, feedback, and the use of calibrated digital systems like TraumaCad can enhance accuracy and confidence in implant selection, ultimately improving surgical outcomes.

Biography:

Amr Mohamed Foad Mohamed is a Trauma & Orthopaedics Registrar at Watford General Hospital with a strong academic and clinical background. He completed Core Surgical Training with a focus on T&O in the East Midlands Deanery and has demonstrated proficiency in managing acute trauma cases and performing complex procedures, including neck of femur and ankle fracture surgeries. He holds a PGCert in Medical Education from Cardiff University and is actively involved in undergraduate and postgraduate teaching with Imperial College London and the University of Leicester. Dr Basha is the first author of a systematic review on buprenorphine for postoperative pain and a co-author in multiple orthopaedic publications. His audit and quality improvement projects have been presented nationally and internationally. He has a long-term interest in hip and knee arthroplasty, robotic surgery, and medical education, aiming to contribute to global orthopaedic outreach work in the future.