Pre-operative templating has become an essential aspect of pre-operative preparation for elective total hip replacement. The techniques involved have evolved from acetates used with analogue radiographs to digital processes. This study audits the accuracy of the TraumaCad software in total hip replacement since its introduction at two centres in the same trust.

The pre and post-operative radiographs of 40 patients undergoing total hip replacement by a single surgeon at a district general hospital were retrospectively reviewed. Patients that had templating of their digital Picture Archiving and Communications Systems (PACS) pelvic images using the TraumaCad software programme (Orthocrat Ltd, Petach-Tikva, Israel) were included. The templated acetabular component and femoral stem was compared to the actual size of acetabular and femoral prostheses inserted at surgery.

The acetabulum was accurately templated in 38.9% of the hips and within ± 1 size in a further 44.4% (total 83.3%). The femoral stem size was accurate in 27.8% of the hips and within ± 1 size in a further 52.8% of the hips (total 80.6%). Such a variation is likely due to the variable positioning of the calibration ball.

TraumaCad is a useful tool in the pre-operative templating of hips successfully predicting the prosthesis components within ± 1 size in the majority of hips studied. However, it should not be relied upon as an absolute measurement of the size of prosthesis to be used, rather be used as a suitable guide to intra-operative stages such as the femoral neck cut position.