Extramedullary versus intramedullary tibial alignment technique in total knee arthroplasty: A meta-analysis of randomized controlled trials

• Main Authors: Huan Bei Zeng, Xiao Zhou Ying, Guang Jun Chen, Xia Qing Yang, Duo Duo Lin, Zhi Jie Li, Hai Xiao Liu
• Format: Article
• Language: English
• Published: Faculdade de Medicina / USP 2015-10-01
• Series: Clinics
• Subjects: Extramedullary; Intramedullary; Total Knee Arthroplasty; Meta-Analysis
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322015001000714&lng=en&tlng=en
• ISSN: 1980-5322

The aim of this study was to establish whether the use of an extramedullary or intramedullary tibial cutting guide leads to superior mechanical leg axis and implant positioning. A meta-analysis of six randomized controlled trials including 350 knees was performed. For the mechanical axis, frontal tibial component angle and tibial slope, there were no significant differences in the mean values or the number of outliers (±3°) between the extramedullary and intramedullary groups. A reduced tourniquet time was associated with the intramedullary guide. No significant difference in the complication rate was noted between the two groups. Neither extramedullary nor intramedullary tibial alignment was more accurate in facilitating the tibial cut. Use of an intramedullary guide results in a shorter tourniquet time and exhibits a similar complication rate as the extramedullary guide.