Optimized Patient Care in the Perioperative Management of Hip and Knee Arthroplasty: Pre-op Planning of THA (Conventional Software, PSI, RAS)

Preoperative templating can be performed on standing conventional pelvic radiographs with a known magnification factor, or more accurately on slit-beam 2D biplanar and 3D computer tomography images. The aim is to analyse the hip biomechanics and to develop a strategy to restore or optimize the relation between pelvis and proximal femur using hip implants. A such, the focus should rather be on a personalized implant choice and positioning, and on anticipating pitfalls, than on implant size. During surgery, converting a preoperative plan into a well functioning hip arthroplasty remains challenging. Patientspecific guides, navigation systems and robotic assisted surgery, can all contribute to an improved execution of the preoperative plan. However, these tools come at a cost that should be balanced against the benefits for the patient.