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Tibial alignment technique and its influence on clinical and functional outcomes following total knee arthroplasty.

Authors
  • Bansal, Mohit R1
  • Back, Diane1
  • Earnshaw, Peter1
  • Sandiford, N A2
  • 1 Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom. , (United Kingdom)
  • 2 Southland Teaching Hospital, Invercargill, New Zealand. , (New Zealand)
Type
Published Article
Journal
Journal of Clinical Orthopaedics and Trauma
Publisher
Elsevier
Publication Date
Jul 01, 2020
Volume
11
Issue
Suppl 4
Identifiers
DOI: 10.1016/j.jcot.2020.04.023
PMID: 32774025
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Restoration of neutral mechanical axis is thought to influence implant survival and function in Total Knee Arthroplasty (TKA). There is no consensus whether Intramedullary (IM) or Extramedullary (EM) tibial alignment technique is superior to achieve this outcome. Study aims to evaluate functional and radiological outcome of TKA using the EM and IM technique. A retrospective study of 400 primary TKA (314 patients) was performed. 200 knees were studied in each IM and EM group, which were matched. Functional assessment was performed using Oxford Knee Score (OKS) and Tibial component alignment measured in coronal and sagittal radiographs. The average coronal and sagittal alignment of the tibial component in IM group was 89.16° and 88°, whereas in EM group, these were 88.1° and 88.5° respectively. The adjusted mean difference change in Pre and Post-operative OKS in IM group compared to EM group was 0.5 (p = 0.52). There was no statistically significant difference in the complications between the two groups. Subgroup analysis of patients with BMI >35 showed predictable coronal tibial alignment with IM technique with fewer outliers. Intramedullary tibial alignment is associated with fewer outliers compared to the extramedullary technique particularly in patients with a BMI over 35. © 2020 Delhi Orthopedic Association. All rights reserved.

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