BMC musculoskeletal disorders · 2025
Intramedullary and extramedullary tibial alignment guides applied to each knee of the same patient resulted in no significant differences in radiological or clinical outcomes.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Rhee Seung Joon, Kim Kyeong Baek, Shin Won Chul, Woo Seung Hun, Do Min Uk, Lee Eun Sung, Lee Sang-Min
Аннотация
BACKGROUND: The superiority of intramedullary versus extramedullary alignment guides in total knee arthroplasty remains controversial, with previous studies reporting inconsistent results. Unlike studies comparing different patient groups, this study controlled for inter-patient variables by applying each method to the left and right knees of the same patients.
METHODS: We retrospectively reviewed 344 patients (688 knees) who underwent bilateral TKA between March 2012 and December 2023. After excluding cases with the same guide used for both knees, revision procedures, PROSTALAC insertion, and loss to follow-up, 94 knees (47 patients) were analyzed. Each patient received IM guidance in one knee and EM guidance in the other, performed by a single experienced surgeon using a standardized technique. Radiological parameters (hip-knee-ankle axis, medial proximal tibial angle, joint line convergence angle, posterior tibial slope) and clinical measures (flexion contracture, further flexion, range of motion) were compared at a minimum of 12 months postoperatively.
RESULTS: No significant differences were found between IM and EM groups in postoperative radiological alignment (HKA axis, p = 0.308; MPTA, p = 0.523; JLCA, p = 0.984; posterior slope, p = 0.269) or clinical outcomes (flexion contracture, p = 0.339; further flexion, p = 0.724). Both methods achieved similar improvements from preoperative values.
CONCLUSIONS: IM and EM guides provided comparable radiographic and clinical outcomes, allowing flexible selection based on patient anatomy and surgical conditions.
METHODS: We retrospectively reviewed 344 patients (688 knees) who underwent bilateral TKA between March 2012 and December 2023. After excluding cases with the same guide used for both knees, revision procedures, PROSTALAC insertion, and loss to follow-up, 94 knees (47 patients) were analyzed. Each patient received IM guidance in one knee and EM guidance in the other, performed by a single experienced surgeon using a standardized technique. Radiological parameters (hip-knee-ankle axis, medial proximal tibial angle, joint line convergence angle, posterior tibial slope) and clinical measures (flexion contracture, further flexion, range of motion) were compared at a minimum of 12 months postoperatively.
RESULTS: No significant differences were found between IM and EM groups in postoperative radiological alignment (HKA axis, p = 0.308; MPTA, p = 0.523; JLCA, p = 0.984; posterior slope, p = 0.269) or clinical outcomes (flexion contracture, p = 0.339; further flexion, p = 0.724). Both methods achieved similar improvements from preoperative values.
CONCLUSIONS: IM and EM guides provided comparable radiographic and clinical outcomes, allowing flexible selection based on patient anatomy and surgical conditions.