Introduction: Total hip arthroplasty is a common orthopedic procedure in which
preoperative planning plays an important role in selecting the appropriate size and
positioning of components. Radiographic imaging is the primary imaging method used in
planning due to its availability, speed, and sufficient diagnostic value. The quality of the
radiographic image, proper projection, and appropriate calibration significantly influence the
accuracy of planning. Purpose: Purpose of this thesis was to investigate the role of
radiographic imaging in planning total hip arthroplasty. We sought to determine which
radiographic projection is most appropriate, which calibration method is the most accurate,
how image quality affects planning, and what role the radiographer plays in ensuring highquality radiographic images. Methods: A descriptive method with a systematic literature
review was used. Two systematic literature reviews were conducted using the PubMed,
EBSCOhost, Scopus, and Google Scholar databases. We included professional articles
published between 2019 and 2026 in Slovenian or English, with full-text access available.
Results: A total of 14 articles were included in the systematic literature review. The findings
indicate that radiographic imaging plays a central role in preoperative planning of total hip
arthroplasty, as it enables the assessment of anatomical structures, selection of component
size, planning of acetabular cup and femoral stem positioning, and evaluation of lower limb
length discrepancy. Discussion and conclusion: Radiographic imaging remains the
fundamental imaging method in preoperative planning of total hip arthroplasty, as it
combines accessibility, speed, and sufficient diagnostic value for most clinical cases. The
literature review shows that two-dimensional planning based on radiographic images is
reliable in determining implant size and positioning, especially when images are obtained
using standardized protocols and properly calibrated. However, radiographic imaging has
important limitations, primarily due to its two-dimensional nature, which does not allow a
complete representation of spatial anatomy. This may present challenges in complex hip
deformities, where more detailed analysis is required. An optimal approach therefore
involves a combination of methods, with radiographic imaging as the foundation and
advanced imaging techniques as a complement in complex clinical situations. The
radiographer plays a key role in the entire process, as proper patient positioning, selection of
technical parameters, and ensuring image quality directly affect the accuracy of planning
and consequently the success of the surgical procedure.
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