A comparative study of intramedullary and extramedullary alignment systems in total knee arthroplasty.

概要

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Proper bone resection is an essential step for performing total knee replacement arthroplasty. Many instrumentation systems have been developed to enable the surgeon to properly place and align the components. The purpose of this study was to determine whether an intramedullary (IM) or extramedullary (EM) alignment system is more accurate for performing proximal tibial resection.Twenty-three patients (29 knees) having Whiteside total knee arthroplasty with IM system and 28 patients (34 knees) having Miller/Galante total knee arthroplasty with EM system were examined in this study. The tibial cutting angle in the frontal and sagittal plane in the IM group was compared with those in the EM group according to postoperative roentgenograms.In the frontal plane, although the mean cutting angle between both groups was not statistically significant, the IM group proved more accurate than the EM group. In the sagittal plane, the mean cutting angle between both groups was statistically significant at the 0.01 level and here also the IM group was more accurate.The results observed in this study would suggested that the IM alignment system is more appropriate for performing proximal tibial resection.