Extramedullary or intramedullary tibial alignment guides: a randomised, prospective trial of radiological alignment

Thienpont, E

doi:10.1302/0301-620x.85b6.0850932

Cited by 2 publications

(1 citation statement)

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“…In addition, although numerous studies have assessed the accuracy of intramedullary and extramedullary guides in obtaining a tibial component alignment 907 to the mechanical axis in the coronal plane, few studies have assessed the accuracy of these guides in positioning the tibial component in the sagittal plane. 8,[14][15][16][17][18][19][20][21][22][23] Achieving the appropriate posterior slope of the tibial component in TKA is crucial because studies have demonstrated that variations in the posterior slope can affect AP, varus/valgus, and rotational flexion stability, along with the AP location of tibiofemoral contact. [24][25][26][27] In one of the few studies assessing postoperative posterior slope alignment with the use of conventional alignment methods, Han et al 18 used an intramedullary rod extending to the distal metaphysis of the tibia for alignment of the tibial cutting block.…”

Section: Discussionmentioning

confidence: 99%

Radiographic Results of an Accelerometer-based, Handheld Surgical Navigation System for the Tibial Resection in Total Knee Arthroplasty

Nam¹,

Cross²,

Deshmane³

et al. 2011

Orthopedics

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In total knee arthroplasty (TKA), intramedullary and extramedullary tibial alignment guides are not proven to be highly accurate in obtaining alignment perpendicular to the mechanical axis in the coronal plane. The objective of this study was to determine the accuracy of an accelerometer-based, handheld surgical navigation system in obtaining a postoperative tibial component alignment within 2° of the intraoperative goal in both the coronal and sagittal planes. A total of 151 TKAs were performed by 2 surgeons using a handheld surgical navigation system to perform the tibial resection. Postoperatively, standing anteroposterior hip-to-ankle radiographs and lateral knee-to-ankle radiographs were performed to determine the varus/valgus alignment and the posterior slope of the tibial components relative to the mechanical axis in both the coronal and sagittal planes. Findings showed that 95.3% of the tibial components were placed within 2° of the intraoperative goal in the coronal plane and 96.1% of the components were placed within 2° of the intraoperative goal in the sagittal plane. Overall, mean postoperative lower-extremity alignment was -0.3°±2.1°, with 97% of patients having an alignment within 3° of a neutral mechanical axis. The handheld surgical navigation system improves the accuracy of the tibial resection and subsequent tibial component alignment in TKA. It is able to combine the accuracy of computer-assisted surgery systems with the ease of use and familiarity of conventional, extramedullary alignment systems, and the ability to adjust both the coronal and sagittal alignments intraoperatively may prove clinically useful in TKA.

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