Abstract
Introduction:
The objective of this study was to assess the success of total knee
arthroplasty with the use of extramedullary positioning osteotomy
templates for limb alignment in contrast to traditional intramedullary
positioning rods.
Methods: Between September 2019 and February 2021,
70 participants underwent total knee arthroplasty with lower limb
positioning using an extramedullary distal femur positioning template
and intramedullary positioning rods. The participants were divided into
two groups each to receive either of the two limb positioning
techniques. The groups were divided randomly and were similar at the
beginning of the study. Therefore, the participants were equally divided
into 35 participants per group. Participants’ indication for the
procedure was severe osteoarthritis s or rheumatoid arthritis, and they
underwent distal femoral osteotomy. The force lines of the lower limb
were identified by locating the center of the head of the femur.
The
patients were monitored for intraoperative bleeding, surgical trauma and
surgical time. They were followed up during the first and second weeks
post-operation to assess for knee joint movement graded using the HSS
knee score and assessed for deviation. Participants were treated equally
throughout the study and during the follow-up phase.
Results: The
participants did not have any statistically significant differences at
the beginning of the study. The intramedullary group had a lesser
average age but without any significant difference from the
extramedullary group. In addition, their HSS knee scores, body mass
index, knee joint range of motion, and the angle of deviation of the
knee, hip, and ankle were of no statistical significance with a p-value
of more than 0.05.
The operation time for the extramedullary group
was approximately 96.57 minutes with a margin of error of (+/-) 8.576
minutes. In contrast, the intramedullary group had an average time of
104.8 minutes and a margin of error of (+/-) 8.864. Intraoperative
bleeding for the extramedullary group was less at approximately 89.97
ml, while it was 95.4ml in the intramedullary group. Postoperative
drainage was also more in the intramedullary group as compared to the
intramedullary group. The differences between both groups were
statistically significant, with a p-value of less than 0.05. There was
no significant difference in HKA angle deviation, coronal plane angle,
and flexion angle of femoral prosthesis (P > 0.05).
Conclusion:
Extramedullary distal femoral osteotomy positioning templates proved
superior to intramedullary positioning rods. The template demonstrated
less surgical trauma hence the lower risk of deformity, less
intraoperative bleeding, therefore, more safety and less risk for
infection than the intramedullary positioning rods
Last Completed Projects
| topic title | academic level | Writer | delivered |
|---|