Maatough Annis, Elbardesy Hany, Mirza Mohammad, Hussain Ali, Atte Nicolas, Kondi Suresh, Kantamaneni Ketan, Patel Nimesh, Oni Tofunmi
Trauma and Orthopaedics, East Kent Hospitals NHS Trust, East Kent Hospitals University NHS Foundation Trust, Ashford, GBR.
Trauma and Orthopaedic Surgery, Cork University Hospital, Cork, IRL.
Cureus. 2025 May 5;17(5):e83501. doi: 10.7759/cureus.83501. eCollection 2025 May.
Purpose of the study Total hip replacements (THRs) are a standard and effective surgical procedure that benefits from preoperative planning. Despite this, no consensus exists on the best preoperative templating tool for THRs. In this study, we compare the single marker to the KingMark™ double-templating system for predicting the size of implants used intraoperatively. Methods This retrospective study compares two cohorts of 50 consecutively selected patients who underwent primary THR under the care of two orthopaedic surgeons. All patients had preoperative anteroposterior (AP) pelvic radiographs to facilitate templating by one of the two methods. The first cohort had surgery with single-marker templated THRs from August to December 2021. The second cohort had THRs templated using the KingMark™ system and underwent surgery between January and April 2022. For both groups, the templated size of the acetabular and femoral implants was compared to the definitive acetabular and femoral implants, respectively. Any patients with a history of previous hip surgery, with developmental abnormality affecting hip anatomy, or requiring bespoke implants were excluded. Results Single-marker templating accurately predicted the femoral implant size in 32% of cases. KingMark™ correctly predicted femoral implant size in 54% of cases, a statistically significant improvement (p=0.04). The mean templated acetabular cup size for the single-marker cohort templated acetabular size was 52.5±4.1, and the definitive acetabular size was 53.6±3.5. The mean templated acetabular cup size for the KingMark™ cohort was 52.0±3.7, and the definitive acetabular cup size was 53.2±4.8. The absolute difference between templated and definitive acetabular implants was 2.3±2.4 and 2.2±2.6, respectively, which was not statistically significant (p=0.84). This is consistent with the rate of accurate acetabular implant prediction for both templating methods (32% for single marker and 30% for KingMark™) with no significant difference (p=0.83). Conclusion The KingMark™ system showed superior accuracy in predicting the femoral stem size in THR over the conventional single mark. However, it's important to note that there was no significant difference between the two methods in predicting the cup size, a key finding of our study.
研究目的 全髋关节置换术（THRs）是一种标准且有效的外科手术，术前规划对其有益。尽管如此，对于THRs最佳的术前模板工具尚无共识。在本研究中，我们比较了单标记法与KingMark™双模板系统在预测术中使用的植入物尺寸方面的差异。方法 这项回顾性研究比较了两组各50例连续入选的患者，他们在两位骨科医生的治疗下接受了初次THR手术。所有患者术前均有骨盆前后位（AP）X线片，以便通过两种方法之一进行模板测量。第一组患者于2021年8月至12月接受单标记模板THR手术。第二组患者使用KingMark™系统进行模板测量，并于2022年1月至4月接受手术。对于两组患者，分别将髋臼和股骨植入物的模板尺寸与最终的髋臼和股骨植入物进行比较。排除任何有髋关节既往手术史、影响髋关节解剖结构的发育异常或需要定制植入物的患者。结果 单标记模板法在32%的病例中准确预测了股骨植入物尺寸。KingMark™系统在54%的病例中正确预测了股骨植入物尺寸，有统计学上的显著改善（p = 0.04）。单标记组模板髋臼杯尺寸的平均值为52.5±4.1，最终髋臼尺寸为53.6±3.5。KingMark™组模板髋臼杯尺寸的平均值为52.0±3.7，最终髋臼杯尺寸为53.2±4.8。模板化与最终髋臼植入物之间的绝对差值分别为2.3±2.4和2.2±2.6，无统计学意义（p = 0.84）。这与两种模板测量方法的髋臼植入物准确预测率一致（单标记法为32%，KingMark™法为30%），无显著差异（p = 0.83）。结论 KingMark™系统在预测THR中股骨柄尺寸方面显示出比传统单标记法更高的准确性。然而，需要注意的是，在预测髋臼杯尺寸方面，两种方法之间没有显著差异，这是我们研究的一个关键发现。
