title: Extramedullary versus intramedullary tibial alignment technique in total knee arthroplasty: A meta-analysis of randomized controlled trials.
abstract: 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.
authors.affiliation: Department of Orthopaedic Surgery, Wenzhou Medical University, Wenzhou, China.
authors.forename: Huan Bei
authors.initials: HB
authors.lastname: Zeng
authors.affiliation: Department of Orthopaedic Surgery, Wenzhou Medical University, Wenzhou, China.
authors.forename: Xiao Zhou
authors.initials: XZ
authors.lastname: Ying
authors.affiliation: Department of Orthopaedic Surgery, Wenzhou Medical University, Wenzhou, China.
authors.forename: Guang Jun
authors.initials: GJ
authors.lastname: Chen
authors.affiliation: Department of Orthopaedic Surgery, Wenzhou Medical University, Wenzhou, China.
authors.forename: Xia Qing
authors.initials: XQ
authors.lastname: Yang
authors.affiliation: Department of Orthopaedic Surgery, Wenzhou Medical University, Wenzhou, China.
authors.forename: Duo Duo
authors.initials: DD
authors.lastname: Lin
authors.affiliation: Department of Orthopaedic Surgery, Wenzhou Medical University, Wenzhou, China.
authors.forename: Zhi Jie
authors.initials: ZJ
authors.lastname: Li
authors.affiliation: Department of Orthopaedic Surgery, Wenzhou Medical University, Wenzhou, China.
authors.forename: Hai Xiao
authors.initials: HX
authors.lastname: Liu
mesh_terms: D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D015982:Bias; D006801:Humans; D011859:Radiography; D016032:Randomized Controlled Trials as Topic; D013977:Tibia / Q000000981:diagnostic imaging / Q000601:surgery*; D013997:Time Factors; D014111:Tourniquets