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Introduction <p>Accurate cup sizing is crucial in total hip arthroplasty (THA). Conventional templating and intra-operative head sizing show inconsistent accuracy, whereas CT-based planning in robotic-assisted THA may offer superior precision. We aimed to compare implanted cup size with both CT-based planning and intra-operative native head sizing, hypothesising that CT planning would provides greater accuracy and consistency.</p> Methods <p>This single-centre study included 619 consecutive robot-assisted primary THAs templated with pre-operative CT scans. Implanted cup size was compared with the pre-operative CT-planned size in all hips, and with the intra-operative measurement of the native femoral head in 299 hips.</p> Results <p>: CT-based planning closely predicted the implanted cup (exact 94.3%; ±1 size 98.7%; mean difference 0.05 ± 0.67&#xa0;mm; <i>r</i> = 0.984, <i>p</i> &lt; 0.001). Implant–native head comparisons showed larger mismatches (3.14 ± 2.31&#xa0;mm; exact 9.4%; ±1 size 40.5%; <i>r</i> = 0.817, <i>p</i> &lt; 0.001). Plan-implant agreement was modestly better in females (<i>p</i> = 0.039) and in smaller head categories (&lt; 50 and 50–54&#xa0;mm) versus &gt; 54&#xa0;mm (<i>p</i> = 0.007). For implant versus head, mismatch magnitude varied by head size, smaller heads tended toward greater relative oversizing, without a sex effect (<i>p</i> = 0.76).</p> Conclusion <p>In robotic THA, CT-based 3-D planning provides near-perfect cup-size prediction and substantially outperforms using the native head as a sizing reference. Residual variation reflects patient-specific factors, chiefly native head size and, to a lesser extent, sex, which should be considered alongside the CT plan. Using native head diameter as a complementary check may further refine pre-operative algorithms and guide intra-operative choices, optimizing component selection for long-term stability and function.</p>

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Computerised Tomography based three dimensional planning predicts cup size with near-perfect accuracy in robotic total hip arthroplasty: a study of six hundred and nineteen hips

  • 期刊论文

  • 发表日期：

    2025年11月27日

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  • Pascal Kouyoumdjian,
  • Thomas Grosso,
  • Youssef Jamaleddine,
  • Rémy Coulomb

摘要

Introduction

Accurate cup sizing is crucial in total hip arthroplasty (THA). Conventional templating and intra-operative head sizing show inconsistent accuracy, whereas CT-based planning in robotic-assisted THA may offer superior precision. We aimed to compare implanted cup size with both CT-based planning and intra-operative native head sizing, hypothesising that CT planning would provides greater accuracy and consistency.

Methods

This single-centre study included 619 consecutive robot-assisted primary THAs templated with pre-operative CT scans. Implanted cup size was compared with the pre-operative CT-planned size in all hips, and with the intra-operative measurement of the native femoral head in 299 hips.

Results

: CT-based planning closely predicted the implanted cup (exact 94.3%; ±1 size 98.7%; mean difference 0.05 ± 0.67 mm; r = 0.984, p < 0.001). Implant–native head comparisons showed larger mismatches (3.14 ± 2.31 mm; exact 9.4%; ±1 size 40.5%; r = 0.817, p < 0.001). Plan-implant agreement was modestly better in females (p = 0.039) and in smaller head categories (< 50 and 50–54 mm) versus > 54 mm (p = 0.007). For implant versus head, mismatch magnitude varied by head size, smaller heads tended toward greater relative oversizing, without a sex effect (p = 0.76).

Conclusion

In robotic THA, CT-based 3-D planning provides near-perfect cup-size prediction and substantially outperforms using the native head as a sizing reference. Residual variation reflects patient-specific factors, chiefly native head size and, to a lesser extent, sex, which should be considered alongside the CT plan. Using native head diameter as a complementary check may further refine pre-operative algorithms and guide intra-operative choices, optimizing component selection for long-term stability and function.