Objective: Radiographic templates have been developed to assist with the preoperative planning process. However, the clinical usefulness of preoperative templating in total knee replacement is still lacking. The present study aims to evaluate the accuracy of preoperative templating in primary total knee replacement.
Material and Method: A retrospective study of 98 patients and 113 knees was carried out. Both the anteroposterior and lateral radiographic views were templated using the templates for DePuy Sigma PFC, fixed bearing total knee system and the template size was documented for each patient pre-operatively. The operative records were then reviewed to determine the size of the implant used during the operation.
Results: The overall accuracy between the preoperative template size and the final implant size was 50.4% for the femoral component and 55.8% for the tibial component. The highest prediction for tibial assessment was the anteroposterior view and the lateral intercondylar view for femoral assessment.
Conclusion: Approximately 50% of the patients had a preoperative template size that matched the actual implant used. Many factors influence the final choice of the prosthesis used during total knee replacement; therefore, the preoperative template size can only be used as a rough guide.

Keywords: Preoperative template, Size, Total knee replacement, Accuracy, Clinical usefulness, Radiographic view