Predicting Implant Size in Total Hip Arthroplasty

BACKGROUND: Efficient resource management is becoming more important as the demand for total hip arthroplasty (THA) increases. The purpose of this study is to evaluate the ability of linear regression and Bayesian statistics in predicting implant size for THA using patient demographic variables. MATERIAL AND METHODS: A retrospective, single-institution joint-replacement registry review was performed on patients who underwent primary THA from 2005 to 2019. Demographic information was obtained along with primary THA implant data. A total of 11,730 acetabular and 8536 femoral components were included. A multivariable regression model was created on a training cohort of 80% of the sample and applied to the validation cohort (remaining 20%). Bayesian posterior probability methods were applied to the training cohort and then tested in the validation cohort to determine the 1%, 5%, and 10% error tolerance thresholds. RESULTS: The most predictive regression model included height, weight, and sex (cup: R(2) = 0.57, all P < .001; stem mediolateral size [M/L]: R(2) = 0.32, all P < .001). Removing weight had a minimal effect and resulted in a more parsimonious model (cup: R(2) = 0.56, all P < .001; stem M/L: R(2) = 0.32, all P < .001). Applying the posterior probability estimate to the validation cohort in the Bayesian model using height, weight, and sex demonstrated high accuracy in predicting the range of required implant sizes (95.3% cup and 90.4% stem M/L size). CONCLUSION: Implant size in THA is correlated with demographic variables to accurately predict implant size using Bayesian modeling. Predictive models such as linear regression and Bayesian modeling can be used to improve operating room efficiency, supply chain inventory management, and decrease costs associated with THA.