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Tibial Alignment in Total Knee Replacement Surgery, Intramedullary Alignment Versus Extramedullary Alignment a Blinded Single Surgeon Study

Background: The clinical success of total knee arthroplasty is positively correlated with good component orientation. Controversy remains as to what is the best tibial alignment technique, this study compares the intramedullary versus the extramedullary surgical alignment guidance methods. Material and Methods: A retrospective study was done on 100 patients during the time period 2007 to 2010. The knee replacements were performed by the same surgeon, 49 procedures were performed via the intramedullary technique and 51 procedures were via the extramedullary technique. The tibiofemoral angle was measured pre-operatively as well as post operatively, the tibial alignment angle was measured post operatively also, the results were then statistically analysed. Results and Conclusion: There was no significant difference between both groups regarding the tibial alignment angles. Both techniques proved accurate in producing an acceptable post operative tibial component alignment angle. We advocate the surgeon may use his/her discretion when deciding upon the method of tibial alignment.