Affiliation:
1. Department of Joint Surgery, The First Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China.
Abstract
Background:
This meta-analysis aimed to compare the efficacy of intramedullary and extramedullary femoral alignment technique in treating total knee arthroplasty (TKA) patients.
Methods:
PubMed, Embase, Cochrane library, Chinese National Knowledge Infrastructure, and Weipu databases were electronically searched. Potential clinical studies that investigated the effect and safety of intramedullary versus extramedullary femoral alignment technique in TKA patients were searched. The primary outcome was lower limb coronal alignment. Stata 12.0 was used for meta-analysis.
Results:
This meta-analysis included 12 prospective randomized controlled studies that reported data on 935 TKA patients. No significant difference was noted in lower limb coronal alignment, coronal alignment of femoral component, sagittal alignment of femoral component and tibial slope between intramedullary and extramedullary alignment techniques (P > .05). Further, extramedullary alignment technique significantly decrease the total blood loss than intramedullary alignment technique (weighted mean difference: −86.52; 95% confidence interval: −115.05–−57.99; P = .000) and subsequently transfusion rate (risk ratio: 0.57; 95% confidence interval: 0.41–0.79; P = .000). Finally, there was no significant difference between intramedullary and extramedullary alignment techniques in terms of the total complications (P > .05).
Conclusions:
The present meta-analysis showed that intramedullary and extramedullary femoral alignment technique had comparable precise profiles. And extramedullary femoral alignment technique could reduce blood loss and blood transfusion. Total complications were comparable between the groups. More randomized controlled trials with large samples are required to verify the comparison of intramedullary and extramedullary femoral alignment technique in TKA patients.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Reference24 articles.
1. Overview of randomized controlled trials in total knee arthroplasty (47,675 patients): what have we learnt?;Matar;J Arthroplasty,2020
2. Intrathecal versus local infiltration analgesia for pain control in total joint arthroplasty.;Cai;J Orthop Surg Res,2020
3. Femoral intramedullary alignment in total knee arthroplasty: indications, results, pitfalls, alternatives, and controversies.;Bono;J Knee Surg,2020
4. Effect of femoral resection on coronal overall alignment after conventional total knee arthroplasty.;Zhao;Chin Med J (Engl),2016
5. Intramedullary vs extramedullary femoral alignment guides: a 15-year follow-up of survivorship.;Meding;J Arthroplasty,2011