Eficácia do uso do templating na artroplastia total do quadril

• Ano de defesa: 2009
• Autor(a) principal: Devito, Fábio Stucchi
• Orientador(a): Chueire, Alceu Gomes
• Banca de defesa: Carvalho Filho, Guaracy , Honda, Emerson Kiyoshi , Ignácio, Helencar , Rudelli, Sérgio Andréa
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Faculdade de Medicina de São José do Rio Preto
• Programa de Pós-Graduação: Programa de Pós-Graduação em Ciências da Saúde::123123123123::600
• Departamento: Medicina Interna; Medicina e Ciências Correlatas::123123123123::600
• País: BR
• Palavras-chave em Português: Pelve; Prótese Total Cimentada; Templating; Radiografia; Planejamento; Artroplastia de Quadril; Protese de Quadril
• Palavras-chave em Inglês: Pelvis; Cemented Total Hip; Prostheses; Templating; X-ray; Planning.; Arrhoplasty, Replacement, Hip; Radiography Hip Prosthesis
• Palavras-chave em Espanhol: Artroplastia de Reemplazo de Cadera; Protese de Cadera; Planificacóin
• Área do conhecimento CNPq: CNPQ::CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA::ORTOPEDIA::123123123123::600
• Link de acesso: http://bdtd.famerp.br/handle/tede/62

Total hip arthroplasty is a surgery with a high success rate, providing pain relief and improvement of the articular mobility. Long-term success is related to the position and orientation of the acetabular and femoral components. Traditional preoperative planning entails radiographic analysis of the pelvis, in which a template is placed on the image, allowing an analysis of the appropriate size of the Exeter cemented prosthesis. Objective: To evaluate the effectiveness of traditional preoperative planning with the use of templating. Patients and Method: Forty-three anteroposterior X-rays were analyzed by three experienced surgeons. The evaluation of each surgeon was compared with the actual prosthesis used in the surgery and also compared with the assessment of the other two surgeons. Cohen's Kappa concordance test and weighted Kappa indexes using quadratic weighting were used for statistical analysis with a confidence interval of 95%. Results: The preoperative evaluations of Surgeons A, B and C were divided into the analysis of the sizes of the acetabular cup, stem and plug of the distal femoral canal. Surgeon A obtained a moderate agreement in relation to the acetabular component and substantial agreements in relation to the stem and plug. Surgeon B had moderate agreement in relation to both the acetabulum and the stem and substantial agreement in relation to the plug. Surgeon C obtained moderate agreement in relation to the analysis of the acetabulum and the plug and substantial agreement for the stem. The intra-observer agreement test demonstrated a prevalence of slight agreement in relation to the acetabulum and substantial agreement in relation to the stem and to the plug. Conclusion: Templating used in preoperative planning proved effective; however, there was a prevalence of slight and moderate agreement in relation to the size of the acetabular component according to the inter- and intra-observer analysis.