Scholarlink

Background <p>The superiority of intramedullary versus extramedullary alignment guides in total knee arthroplasty remains controversial, with previous studies reporting inconsistent results. Unlike studies comparing different patient groups, this study controlled for inter-patient variables by applying each method to the left and right knees of the same patients.</p> Methods <p>We retrospectively reviewed 344 patients (688 knees) who underwent bilateral TKA between March 2012 and December 2023. After excluding cases with the same guide used for both knees, revision procedures, PROSTALAC insertion, and loss to follow-up, 94 knees (47 patients) were analyzed. Each patient received IM guidance in one knee and EM guidance in the other, performed by a single experienced surgeon using a standardized technique. Radiological parameters (hip–knee–ankle axis, medial proximal tibial angle, joint line convergence angle, posterior tibial slope) and clinical measures (flexion contracture, further flexion, range of motion) were compared at a minimum of 12 months postoperatively.</p> Results <p>No significant differences were found between IM and EM groups in postoperative radiological alignment (HKA axis, <i>p</i> = 0.308; MPTA, <i>p</i> = 0.523; JLCA, <i>p</i> = 0.984; posterior slope, <i>p</i> = 0.269) or clinical outcomes (flexion contracture, <i>p</i> = 0.339; further flexion, <i>p</i> = 0.724). Both methods achieved similar improvements from preoperative values.</p> Conclusions <p>IM and EM guides provided comparable radiographic and clinical outcomes, allowing flexible selection based on patient anatomy and surgical conditions.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Intramedullary and extramedullary tibial alignment guides applied to each knee of the same patient resulted in no significant differences in radiological or clinical outcomes

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年12月27日

查看全文
  • Seung Joon Rhee,
  • Kyeong Baek Kim,
  • Won Chul Shin,
  • Seung Hun Woo,
  • Min Uk Do,
  • Eun Sung Lee,
  • Sang-Min Lee

摘要

Background

The superiority of intramedullary versus extramedullary alignment guides in total knee arthroplasty remains controversial, with previous studies reporting inconsistent results. Unlike studies comparing different patient groups, this study controlled for inter-patient variables by applying each method to the left and right knees of the same patients.

Methods

We retrospectively reviewed 344 patients (688 knees) who underwent bilateral TKA between March 2012 and December 2023. After excluding cases with the same guide used for both knees, revision procedures, PROSTALAC insertion, and loss to follow-up, 94 knees (47 patients) were analyzed. Each patient received IM guidance in one knee and EM guidance in the other, performed by a single experienced surgeon using a standardized technique. Radiological parameters (hip–knee–ankle axis, medial proximal tibial angle, joint line convergence angle, posterior tibial slope) and clinical measures (flexion contracture, further flexion, range of motion) were compared at a minimum of 12 months postoperatively.

Results

No significant differences were found between IM and EM groups in postoperative radiological alignment (HKA axis, p = 0.308; MPTA, p = 0.523; JLCA, p = 0.984; posterior slope, p = 0.269) or clinical outcomes (flexion contracture, p = 0.339; further flexion, p = 0.724). Both methods achieved similar improvements from preoperative values.

Conclusions

IM and EM guides provided comparable radiographic and clinical outcomes, allowing flexible selection based on patient anatomy and surgical conditions.