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J Am Acad Orthop Surg, Vol 13, No 7, November 2005, 455-462.
© 2005 the American Academy of Orthopaedic Surgeons
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Preoperative Planning for Primary Total Hip Arthroplasty

Alejandro González Della Valle, MD, Douglas E. Padgett, MD and Eduardo A. Salvati, MD

Dr. González Della Valle is Assistant Attending Orthopaedic Surgeon, Hospital for Special Surgery, New York, NY, and Instructor in Orthopaedic Surgery, Weill Medical College, Cornell University, New York. Dr. Padgett is Attending Orthopaedic Surgeon, Hospital for Special Surgery, and Associate Professor of Orthopaedic Surgery, Weill Medical College, Cornell University. Dr. Salvati is Director of the Hip and Knee Service, Hospital for Special Surgery, and Clinical Professor of Orthopaedic Surgery, Weill Medical College, Cornell University.

None of the following authors or the departments with which they are affiliated has received anything of value from or owns stock in a commercial company or institution related directly to or indirectly to the subject of this article: Dr. González Della Valle, Dr. Padgett, and Dr. Salvati.

This study was partially funded by the generous donation of Daniel and Geraldine Soba, Trustees of the Grace R. and Alan D. Marcus Foundation.

Reprint requests: Dr. González Della Valle, 535 East 70th Street, New York, NY 10021.

Preoperative planning is of paramount importance in obtaining reproducible results in modern hip arthroplasty. Planning helps the surgeon visualize the operation after careful review of the clinical and radiographic findings. A standardized radiograph with a known magnification should be used for templating. The cup template should be placed relative to the ilioischial line, the teardrop, and the superolateral acetabular margin, so that the removal of the supportive subchondral bone is minimal and the center of rotation of the hip is restored. When acetabular abnormalities are encountered, additional measures are necessary to optimize cup coverage and minimize the risk of malposition. Templating the femoral side for cemented and cementless implants should aim to optimize limb length and femoral offset, thereby improving the biomechanics of the hip joint. Meticulous preoperative planning allows the surgeon to perform the procedure expediently and precisely, anticipate potential intraoperative complications, and achieve reproducible results.




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A. Kulkarni, P. Partington, D. Kelly, and S. Muller
Disc calibration for digital templating in hip replacement
J Bone Joint Surg Br, December 1, 2008; 90-B(12): 1623 - 1626.
[Abstract] [Full Text] [PDF]


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